Genetic markers of mental illness

ABSTRACT

This invention relates to genetic markers of mental illness, e.g., schizophrenia (SZ), and methods of use thereof.

CLAIM OF PRIORITY

This application is a continuation of U.S. patent application Ser. No. 14/703,753, filed on May 4, 2015, which is a continuation of U.S. patent application Ser. No. 14/066,120, filed on Oct. 29, 2013 (issued as U.S. Pat. No. 9,040,241), which is a divisional of U.S. patent application Ser. No. 12/523,262, filed on Jul. 15, 2009 (issued as U.S. Pat. No. 8,586,308), which is the U.S. National Stage under 35 U. S.C. §371 of International Patent Application Number PCT/US2009/031322, filed on Jan. 16, 2009, which claims the benefit of U.S. Provisional Patent Application Ser. No. 61/021,756, filed on Jan. 17, 2008, the entire contents of each of which are hereby incorporated by reference.

FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

This invention was made with Government support under Grant Nos. R43 MH078437, N01 MH900001, and MH074027, awarded by the National Institutes of Health. The Government has certain rights in the invention.

ACKNOWLEDGEMENT

This invention was made with an award from the Kentucky Cabinet for Economic Development, Department of Commercialization and Innovation, under Grant Agreement KSTC-184-512-07-007 with the Kentucky Science and Technology Corporation.

TECHNICAL FIELD

This invention relates to genetic markers of mental illness, e.g., schizophrenia (SZ), and methods of use thereof, e.g., for determining a subject's risk of developing a mental illness, e.g., SZ.

BACKGROUND

Schizophrenia (SZ) is a severe and persistent debilitating psychiatric illness that is generally associated with considerable morbidity and extreme disability. Due to the severity of this disorder, especially the negative impact of a psychotic episode on a patient, and the diminishing recovery after each psychotic episode, there is a need to more conclusively identify individuals who have or are at risk of developing SZ, for example, to confirm clinical diagnoses, to allow for prophylactic therapies, to determine appropriate therapies based on their genotypic subtype, and to provide genetic counseling for prospective parents with a history of the disorder.

Various genes and chromosomes have been implicated in etiology of SZ. Whole genome scans for genes involved in SZ and related SZ-spectrum disorders (including schizotypal personality disorder (SPD) and schizoaffective disorder (SD)) have implicated numerous autosomes as having a role in the genetic etiology of SZ and related SZ-spectrum disorders (Badner et al., Mol. Psychiatry 7:405-411 (2002) Bennett et al., Mol. Psychiatry 7:189-200 (2002) Cooper-Casey et al., Mol. Psychiatry 10:651-656 (2005) Devlin et al., Mol. Psychiatry 7:689-694 (2002) Fallin et al., Am. J. Hum. Genet. 73:601-611 (2003) Ginns et al., Proc. Natl. Acad. Sci. U.S.A 95:15531-15536 (1998) Jablensky, Mol. Psychiatry (2006) Kirov et al., J. Clin. Invest 115:1440-1448 (2005) Norton et al., Curr. Opin. Psychiatry 19:158-164 (2006) Owen et al., Mol. Psychiatry 9:14-27 (2004)). Generally, these linkage scans have are too low in resolution to identify specific genes, but increasingly, transmission disequilibrium (TDT, family-based association) and Case/Control association studies have evaluated a number of positional candidate genes with a good measure of success (Fallin et al., Am. J. Hum. Genet. 77:918-936 (2005)).

SUMMARY

The invention includes methods for assessing genetic risk, aiding in diagnosis, and/or stratifying patient populations in order to select optimal treatments based on evaluation of single nucleotide polymorphisms (SNPs) for a number of bioinformatically identified genes on chromosomes 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, and 20 relating to SZ (which herein is broadly defined to include SZ-spectrum disorders, e.g., including schizophrenia (SZ), schizotypal personality disorder (SPD) and schizoaffective disorder (SD)). Exemplary SNPs delimiting each gene region (referred to herein as “delimiting SNPs”) are given along with exemplary test SNPs that can be used to capture significant haplotype variation in these genes. Important variants can be identified via TDT using families with multiple affected individuals (such as those collected CCGS) and verified by Case/Control comparisons using the SNP markers presented herein. Using SNP markers lying between the delimiting SNPs, inclusive, and identical to or in linkage disequilibrium with the exemplary SNPs, one can determine the haplotypes in these genes relating to genetic risk of developing SZ. These haplotypes can then be used to determine risk of developing SZ by Case/Control studies as shown in Example 1. The allelic and genotypic variants thus identified can be used for assessing genetic risk, to aid in diagnosis, and/or to stratify patient population in order to select optimal treatments (atypical antipsychotic, typical antipsychotic, and/or psychosocial intervention) for patients.

Numerous pathways have been implicated in SZ etiology. As described herein, genes identified as associated with increased risk of SZ are involved in a number of pathways including: glutamate signaling and metabolism, cell adhesion, cytoskeletal architecture, vesicle formation and trafficking, G-protein coupled receptors, carrier proteins and transporters, ion channels (e.g., potassium channels), and potassium current signaling molecules, cell cycle modulators, neuronal development, calcium/calmodulin signaling, neuropeptide signaling, inositol signaling (e.g., phosphatidylinositol kinases), insulin signaling, diacylglycerol signaling, and several additional genes identified by virtue of their interaction with genes in high impact pathways and their expression in the central nervous system.

Table A lists gene names and delimiting SNPs for bioinformatically identified genes relating to SZ-spectrum disorders. All of the genes are human.

TABLE A Delimiting SNPs for Novel SZ Genes (NCBI Genome Build 36.2) Gene Chrom. SNP 1 Location (bp) SNP 2 Location (bp) Delimiting SNPs for Potassium Channel and Related Genes KCNC4 1 rs1359149 110,553,057 rs11578913 110,578,628 KCNA10 1 rs1281177 110,859,992 rs17025957 110,863,572 KCND3 1 rs197422 112,119,035 rs10745323 112,345,127 KCNH1 1 rs12126648 208,922,743 rs1538287 209,377,867 ANK3 10 rs1050745 61,457,255 rs1551684 61,820,209 KCNQ1 11 rs11022827 2,414,908 rs2239897 2,848,541 KCNC1 11 rs7949069 17,711,203 rs1236205 17,760,287 Delimiting SNPs for Cell Adhesion and Related Genes RP1-21O18.1 1 rs9663010 15,143,609 rs2235789 15,314,645 CTNND1 11 rs558653 57,285,706 rs652908 57,360,585 DACT1 14 rs464582 58,171,201 rs160472 58,185,201 CDH11 16 rs35148 63,536,690 rs7204464 63,731,895 Delimiting SNPs for Vesicle-Related Genes VAMP4 1 rs10913508 169,935,102 rs7556644 169,979,491 SYT14 1 rs9429830 208,177,160 rs11119426 208,407,592 BRSK2 11 rs7395835 1,365,307 rs1554857 1,441,643 SYT13 11 rs2863172 45,217,918 rs11038382 45,269,392 STX2 12 rs2632601 129,834,650 rs7962097 129,890,817 RTN1 14 rs17255975 59,131,314 rs7144589 59,407,620 UNC13C 15 rs11071015 52,092,152 rs9920150 52,708,142 SV2B 15 rs11630131 89,569,404 rs7169918 89,640,060 Delimiting SNPs for Genes Related to Glutamate Pathways Gcom1 15 rs1908202 55,669,589 rs1808478 55,797,051 GRINL1A 15 rs1908202 55,669,589 rs1808478 55,797,051 GOT2 16 rs2042445 57,296,647 rs4238801 57,329,680 Delimiting SNPs for G-Protein Coupled Receptor Related Genes RHOG 11 rs1055640 3,803,869 rs4406820 3,819,109 GPR135 14 rs17255731 58,964,865 rs4898989 59,005,097 AKAP13 15 rs1533124 83,674,688 rs11637212 84,094,101 Delimiting SNPs for Hormone, Inositol, and Diacylglyceride Related Genes HSD17B12 11 rs12364003 43,657,684 rs11037691 43,848,213 IGF1R 15 rs35554027 97,008,574 rs702497 97,319,104 Delimiting SNPs for Cytoskeletal, Myosin, Actin and Microtubule Related Genes EVL 14 rs1190954 99,601,206 rs35257667 99,689,766 KATNAL2 18 rs9304340 42,780,580 rs1434528 42,886,321 Delimiting SNPs for Genes for Carrier Proteins and Transporters SLC6A17 1 rs924181 110,481,637 rs545849 110,546,538 SLC16A4 1 rs10857820 110,706,448 rs12127781 110,738,080 SLC6A5 11 rs894747 20,575,165 rs1401793 20,632,993 SLC17A6 11 rs1155821 22,315,296 rs2593644 22,357,697 SLCO3A1 15 rs11858120 90,196,267 rs1060206 90,509,554 Delimiting SNPs for Cell Cycle and Tumor Suppressor/Promoter Related Genes RERE 1 rs1055236 8,326,680 rs914994 8,839,799 FASLG 1 rs763110 170,894,121 rs12135884 170,905,123 DEAF1 11 rs936465 633,568 rs6597990 687,761 HCCA2 11 rs12786504 1,446,780 rs2334652 1,462,030 PTPN5 11 rs873670 18,705,395 rs7932938 18,771,871 CHFR 12 rs1531822 131,925,194 rs3741494 131,974,573 TTC5 14 rs10130942 19,826,245 rs10873395 19,845,685 FUSSEL18 18 rs2137289 43,006,123 rs892583 43,170,372 SMAD2 18 rs1792666 43,617,212 rs2000709 43,713,512 SMAD7 18 rs9944944 44,699,493 rs736839 44,782,063 SMAD4 18 rs620898 46,763,146 rs12456284 46,863,966 Delimiting SNPs for Genes Involved in Neuronal Development and Plasticity DNM3 1 rs6701033 170,076,599 rs13932 170,678,391 TOLLIP 11 rs5744038 1,252,012 rs5743854 1,287,830 DUSP8 11 rs6578504 1,532,811 rs10734456 1,563,922 NAV2 11 rs890136 19,687,211 rs2246192 20,098,415 LRRC4C 11 rs11035693 40,091,818 rs10128639 40,275,738 RTN4RL2 11 rs2729363 56,983,430 rs2955849 57,005,697 DTX4 11 rs10896947 58,694,659 rs544864 58,735,516 ULK1 12 rs11246867 130,943,970 rs7978708 130,977,857 NDRG2 14 rs1263871 20,553,926 rs1243451 20,564,197 JPH4 14 rs12897422 23,102,867 rs222732 23,129,120 DAAM1 14 rs17095965 58,718,491 rs4127823 58,926,458 NEDD4 15 rs4424863 53,905,753 rs1509408 54,073,605 RGMA 15 rs12438714 91,386,979 rs4114 91,443,429 N4BP1 16 rs9937623 47,129,091 rs9936446 47,203,308 NDRG4 16 rs7202037 57,054,471 rs2280397 57,109,729 CDH8 16 rs4131634 60,243,900 rs9302540 60,629,024 BEAN 16 rs6499082 64,992,072 rs12445633 65,114,761 KIAA0513 16 rs1875246 83,617,069 rs1466864 83,691,111 DYM 18 rs288812 44,821,479 rs17725481 45,241,155 DCC 18 rs7753970 48,119,269 rs2270954 49,311,296 BMP7 20 rs6014947 55,177,906 rs2208404 55,277,143 TMEPAI 20 rs6025689 55,656,857 rs6015068 55,734,303 Delimiting SNPs for Calcium/Calmodulin Related Genes CAMTA1 1 rs449250 6,720,271 rs228651 7,833,686 CACNA1E 1 rs541886 179,718,012 rs635118 180,037,358 CAMK1G 1 rs17014820 207,823,042 rs926387 207,854,836 RIMBP2 12 rs1496858 129,444,850 rs7963990 129,571,289 Delimiting SNPs for Genes Involved in Hereditary Hearing Loss DPH3 3 rs2292614 16,276,795 rs2245708 16,281,022 EXOC2 6 rs10900954 428,817 rs13205146 638,473 USH1C 11 rs4756895 17,470,828 rs2073582 17,523,687 OTOG 11 rs2073582 17,523,687 rs11024358 17,624,137 SERGEF 11 rs1236205 17,760,287 rs1133758 17,998,369 EML1 14 rs10140193 99,328,197 rs7149272 99,487,743 PMP22 17 rs230938 15,071,845 rs179521 15,113,946 Delimiting SNPs for Genes Encoding Zn-Finger Proteins PRDM2 1 rs2487657 13,894,681 rs979932 13,987,558 ZFP91-CNTF 11 rs1944055 58,099,205 rs4319530 58,156,405 ZNF423 16 rs193907 48,080,956 rs12443775 48,418,620 Delimiting SNPs for Brain-expressed Genes (not otherwise specified) PER3 1 rs172933 7,767,267 rs707472 7,828,595 RABGAP1L 1 rs6681627 172,393,365 rs12126129 173,194,998 PHACS 11 rs178512 44,043,887 rs2285029 44,062,444 YPEL4 11 rs1798177 57,168,726 rs1647394 57,175,164 KIAA1853 12 rs7979864 117,902,236 rs722307 118,094,760 KIAA1545 12 rs10870551 131,567,365 rs7294615 131,678,218 TEP1 14 rs1713418 19,904,649 rs1760890 19,951,629 WDR25 14 rs2273802 99,912,652 rs10151709 100,067,090 BEGAIN 14 rs11628965 100,071,902 rs7140556 100,106,211 HERC2 15 rs7495174 26,017,833 rs1614575 26,236,593 ADAM10 15 rs3764196 56,674,302 rs514049 56,829,655 KLHL25 15 rs11637212 84,094,101 rs7181017 84,145,916 NETO2 16 rs1551188 45,616,796 rs7184206 45,736,527 CBLN1 16 rs3743777 47,869,517 rs9935379 47,884,582 KIAA0182 16 rs4240810 84,182,628 rs3815795 84,269,606 C16orf74 16 rs11644122 84,298,251 rs301143 84,342,400 COX10 17 rs4792434 13,912,946 rs7218697 14,074,153 KIAA0427 18 rs1039989 44,318,592 rs752151 44,697,296

In one aspect, the invention includes methods for obtaining information regarding a subject's risk for developing SZ, i.e., determining the subject's risk of developing SZ. The methods include obtaining a test haplotype associated with schizophrenia as described herein. The methods can also include obtaining a sample comprising genomic DNA (gDNA) from the subject, and determining the identity, absence or presence of a test haplotype associated with SZ as described herein. In some embodiments, the methods include obtaining a test haplotype for the subject comprising at least one test SNP marker that is found within the region delimited by SNP1 and SNP2, inclusive, for a given gene as specified in Table A, or comprising one or more of the exemplary SNP markers for each gene, as specified in the Examples and/or SNP markers in linkage disequilibrium with these markers, wherein the haplotype provides information regarding the subject's risk of developing SZ, SD, or SPD. In some embodiments, the test marker is a marker listed in one or more genes of Table A that is in linkage disequilibrium (defined by correlation, [r²]≧0.5) with a marker listed in Table A in Table B as shown in the Examples, wherein the haplotype provides information regarding the subject's risk of developing SZ, e.g., markers lying between the exemplary SNPs for a gene listed in Table A, but not explicitly listed in the Examples.

In some embodiments, the test haplotype includes at least one marker lying between delimiting SNPs (SNP1 and SNP2), inclusive, for a given gene as specified in Table A, e.g., the exemplary delimiting SNPs listed in Table A; other delimiting SNPs can be chosen from other SNPs known in the art, e.g., the exemplary test SNPs described herein. In some embodiments, the test haplotype includes two or more markers from one gene. In some embodiments, the test genotype includes at least two markers, each from a different gene listed in Table A.

In some embodiments, the test haplotype includes at least one marker lying between the SNP1 and SNP2, inclusive, for a given gene as specified in Table A and provides information regarding a subject's risk of developing SZ under a narrower (DSM III/DSM IV) disease definition.

In some embodiments, the methods include obtaining a test haplotype for the subject by determining the genotype of at least one test marker listed in Table B, or a test marker that lies between the delimiting markers listed in Table A and that is in linkage disequilibrium (LD, defined by correlation, [r²]≧0.5) with markers listed in Table B, wherein the test haplotype indicates the subject's risk of developing SZ. In some embodiments, the at least one test marker is in the KIAA0182 gene or the KIAA0427 gene. In some embodiments, the test marker is selected from the group consisting rs736845; rs994060; rs381579; rs217556; rs8095199; or is a test marker in LD with these markers.

In some embodiments, the methods described herein can be used for predicting a human subject's likely response to an antipsychotic medication. The methods include obtaining a test haplotype for the subject by determining the genotype for at least one test marker listed in Table B, or at least one test marker that lies between the delimiting markers in Table A and that is in linkage disequilibrium (LD) (defined by correlation, [r2]≧0.5) with a marker listed in Table B, wherein the test haplotype indicates the subject's likely response, e.g., likelihood of responding positively (i.e., an improvement in one or more symptoms of the disease) or negatively (i.e., with no improvement, or even a worsening, of one or more symptoms of the disease, or with excessive side effects) to an antipsychotic medication. A number of antipsychotic medications are known in the art and can include, for example, olanzapine, risperidone, quetiapine, perphenazine, and ziprasidone.

In some embodiments, the treatment is administration of olanzapine, and the at least one test marker is in a gene selected from the group consisting of C16orf74, synaptic vesicle glycoprotein 2B (SV2B), calmodulin binding transcription activator 1 (CAMTA1), otogelin (OTOG), ras homolog gene family, member G (RHOG). In some embodiments, the test marker is selected from the group consisting of rs230535; rs373835; rs386061; rs449250; rs657739; rs657740; rs755475; rs755475; rs141798; rs110300; rs145172; rs100349; rs108328; rs202348; rs110243; rs11024358; or is a test markers in LD with one of these markers, and the test haplotype indicates the subject's likely response to administration of olanzapine.

In some embodiments, the treatment is administration of risperidone, and the at least one test marker is in a gene selected from the group consisting of neural precursor cell expressed, developmentally down-regulated 4 (NEDD4), cadherin 8, type 2 (CDH8), deformed epidermal autoregulatory factor 1 (DEAF1), hect domain and RLD 2 (HERC2). In some embodiments, the test marker is selected from the group consisting of rs230357; rs230358; rs139713; rs805733; rs930254; rs110754; rs136991; rs197879; rs649880; rs993999; rs496314; rs659799; rs936465; rs659799; rs110743; rs163516; rs223828; rs7495174; or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the subject's likely response to administration of risperidone.

In some embodiments, the treatment is administration of quetiapine, and the at least one test marker is in a gene selected from the group consisting of catenin (cadherin-associated protein), delta 1 (CTNND1), reticulon 1(RTN1), A kinase (PRKA) anchor protein 13 (AKAP13), potassium voltage-gated channel, shaker-related subfamily, member 10 (KCNA10), solute carrier family 17 (sodium-dependent inorganic phosphate cotransporter), member 6 (SLC17A6). In some embodiments, the test marker further is selected from the group consisting of: rs207835; rs110265; rs115582; rs207835; rs224671; rs376845; rs708228; rs108966; rs115701; rs215663; rs652908; rs105399; rs206182; rs206182; rs206182; rs338523; rs407525; rs407525; rs484289; rs484307; rs484307; rs716216; rs110735; rs101450; rs127174; rs17310036; or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the subject's likely response to administration of quetiapine.

In some embodiments, the treatment is administration of perphenazine, and the at least one test marker is in a gene selected from the group consisting of secretion regulating guanine nucleotide exchange factor (SERGEF) potassium voltage-gated channel, subfamily H (eag-related), member 1 (KCNH1), functional smad suppressing element 18 (FUSSEL18). In some embodiments, the test marker is selected from the group consisting of: rs177022; rs139302; rs1528; rs172424; rs211130; rs211137; rs211146; rs228323; rs105028; rs177854; rs266877; rs723610; rs892583; or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the subject's likely response to perphenazine.

In some embodiments, the treatment is administration of ziprasidone, and the at least one test marker is in a gene selected from the group consisting of unc-13 homolog C (C. elegans) (UNC13C), cerebellin 1 precurso (CBLN1), checkpoint with forkhead and ring finger domains (CHFR). In some embodiments, the test marker is selected from the group consisting of: rs129109; rs110764; rs993537; rs125945; rs116390; rs802519; rs930218; rs230653; rs4758954; or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the subject's likely response to administration of ziprasidone.

In some embodiments, the treatment is administration of an antipsychotic drug, and the at least one test marker is in a gene selected from the group consisting of cadherin 11, type 2, OB-cadherin (osteoblast) (CDH11), deleted in colorectal carcinoma (DCC), Usher syndrome 1C (autosomal recessive, severe) (USH1C). In some embodiments, the test marker is selected from the group consisting of: rs35144; rs35148; rs35186; rs35195; rs35144; rs222908; rs950278; rs143174; rs124574; rs494025; rs750690; rs650823; rs139333; rs152023; rs105557; rs105557; rs207222; rs475689; rs16770, or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the subject's likely response to administration of an antipsychotic.

In some embodiments, the test haplotype provides information regarding a subject's risk (or likelihood) of having a particular endophenotype, and/or a higher or lower level (e.g., severity) of the endophenotype, e.g., of one or more specific parameters of the PANSS scale, e.g., one or more symptoms, e.g., hallucinations, paranoia, anxiety, depression, or grandiosity, as well as response or lack of response to drugs and comorbidity for substance and alcohol abuse.

In another aspect, the invention provides methods for predicting the degree of severity of a psychiatric endophenotype in a human subject. The methods include obtaining a test haplotype for the subject by determining the genotype for at least one test marker listed in Table B, or at least one test markers that lies between the delimiting markers listed in Table A and that is in linkage disequilibrium (LD) defined by correlation, [r²]≧0.5) with a marker in Table B, wherein the test haplotype indicates the likely degree of severity of a psychiatric endophenotype in the subject. In some embodiments, the psychiatric endophenotype is a quantitative trait that can be measured using one or more of PANSS Total composite score, PANSS Positive composite score, PANSS Negative composite score, and PANSS General Psychopathology composite score.

In some embodiments, the one or more test markers are from calcium channel, voltage-dependent, R type, alpha 1E subunit (CACNA1E), echinoderm microtubule associated protein like 1 (EML1), katanin p60 subunit A-like 2 (KATNAL2) genes. In some embodiments, the test marker is selected from the group consisting of rs174946; rs199960; rs385609; rs465267; rs704326; rs218709; rs224722; rs257103; rs257604; rs723351; rs930434; rs996138; rs225071; rs111605; rs111605; rs124336; rs657575; rs746698; rs227370; rs2273704; or is a test marker in linkage disequilibrium with one of these markers. The test haplotype indicates the likely degree of severity of a psychiatric endophenotype in the subject.

In some embodiments, the psychiatric endophenotype comprises one or more of: a Positive Symptom selected from the group consisting of P1-delusions, P2-conceptual disorganization, P3-hallucinatory behavior, P4-excitement, P5-grandiosity, P6-suspiciousness, P7-hostility; a Negative Symptom selected from the group consisting of N1-blunted affect, N2-emotional withdrawal, N3-poor rapport, N4-passive/apathetic social withdrawal, N5-difficulty in abstract thinking, N60 lack of spontaneity and flow of conversation, N7-stereotyped thinking; or a general psychopathology symptom selected from the group consisting of G1-somatic concern, G2-anxiety, G3-guilt feelings, G4-tension, G5-mannerisms and posturing, G6-depression, G7-motor retardation, G8-uncooperativeness, G9-unusual thought content, G10-disorientation, G11-poor attention, G12-lack of judgment and insight, G13 disturbance of volition, G14-poor impulse control, G15-preoccupation, and G16-active social avoidance.

In some embodiments, the at least one test marker is from a gene selected from the group consisting of DPH3, KTI11 homolog (DPH3), insulin-like growth factor I receptor (IGF1R), calcium/calmodulin-dependent protein kinase IG (CAMK1G), neuron navigator 2 (NAV2), bone morphogenetic protein 7 (BMP7). In some embodiments, the test marker is selected from the group consisting of rs224572; rs842257; rs859703; rs224570; rs496543; rs112473; rs187961; rs268479; rs108332; rs712564; rs10375; rs601494; rs230198; or is a test marker that is in linkage disequilibrium with one of these markers. The test haplotype indicates the likely severity of a psychiatric endophenotype in the subject.

The methods described herein can include obtaining a haplotype that includes two or more, e.g., two, three, four, five, or six markers.

Additionally, the methods can include determining the presence or absence of other markers known to be associated with SZ, SD, or SPD, e.g., outside of a region identified herein. A number of other such markers are known in the art, e.g., as described herein.

The subject can be a human (e.g., a patient having, or at risk of, SZ). In one embodiment, the subject is a patient having previously diagnosed SZ, SD, or SPD (e.g., a patient suffering from early, intermediate or aggressive SZ, SD, or SPD). In some embodiments, the methods described herein are used to obtain information regarding a subject's risk of developing SZ wherein the disorder is other than catatonic schizophrenia. In some embodiments, the subject is of Caucasian (CA) descent, i.e., has one or more ancestors who are CA.

In one embodiment, a subject to be evaluated by a method described herein is a subject having one or more risk factors associated with SZ, SD, or SPD. For example, the subject may have a relative afflicted with SZ, e.g., one or more of a grandparent, parent, uncle or aunt, sibling, or child who has or had SZ, SD, or SPD; the subject may have a genetically based phenotypic trait associated with risk for SZ, SD, or SPD (e.g., eye tracking dysfunction); deficits in working (short-term) memory; and/or mixed-handedness (the use of different hands for different tasks), particularly in females.

In some embodiments, the subject is a child, fetus, or embryo, and one of the subject's relatives, e.g., a parent or sibling, of the child, fetus, or embryo has SZ, SD, or SPD. In this case, the presence in the child, fetus, or embryo of a haplotype described herein that is shared with the affected parent, but not with the non-affected parent, indicates that the child, fetus, or embryo has an increased risk of developing SZ. In some embodiments, the subject has no overt or clinical signs of SZ, SD, or SPD.

In some embodiments, obtaining a test haplotype includes obtaining a sample comprising DNA from the subject; and determining the identity, presence or absence of at least one test marker that is SNP marker that is found within the region delimited by SNP1 and SNP2, inclusive, for a given as specified in Table A, or comprising one or more of the exemplary SNP markers for each gene, as specified in the Table B and/or SNP markers in linkage disequilibrium with these markers (in the particular population) in the DNA. The sample can be obtained, e.g., from the subject by a health care provider, or provided by the subject without the assistance of a health care provider.

In some embodiments, obtaining a test haplotype includes reviewing a subject's medical history, wherein the medical history includes information regarding the presence or absence of at least one test SNP marker that is found within the region delimited by SNP1 and SNP2, inclusive, for a given gene as specified in Table A, or comprising one or more of the exemplary SNP markers for each gene, as specified in Table B, and/or SNP markers in linkage disequilibrium with these markers, in the subject.

In some embodiments, the methods described herein include obtaining a reference haplotype including a reference marker that corresponds to a test marker, and comparing the test haplotype to the reference haplotype. A reference marker that “corresponds to” a test marker is the same marker. For example, if the test haplotype includes rs10766410 in the OTOG gene, then the reference haplotype should also include rs10766410 for comparison purposes; or if the test haplotype includes rs553042 in the CACNA1E gene, then the reference haplotype should also include rs553042 for comparison purposes. In methods where the haplotype analysis is performed to determine risk of developing SZ, the sharing of a haplotype (e.g., of some or all of the marker alleles) between the test haplotype and a reference haplotype is indicative of whether there is an increased likelihood that the subject will develop SZ. The reference haplotype can be from a relative, e.g., a first or second degree relative, or from an unrelated individual (or population), that has been identified as either having or not having SZ, SD, or SPD. Optionally, a reference haplotype is also obtained from an unaffected person, e.g., an unaffected relative, and lack of sharing of a haplotype of a haplotype between the test haplotype and the reference haplotype indicates that the subject has an increased risk of developing SZ.

In methods where the haplotype analysis is performed to determine risk of having a particular endophenotype or endophenotype severity (e.g., on the PANSS scale), the sharing of a haplotype (e.g., of some or all of the marker alleles) between the test haplotype and a reference haplotype is indicative of whether there is an increased likelihood that the subject will have an elevated (high) or low value for that specific endophenotype. For example, the reference haplotype can be from a relative, e.g., a first or second degree relative, or from an unrelated individual (or population), e.g., a person that has been diagnosed with SZ, and further identified as either having or not having an elevated value for the specific endophenotype. In some embodiments, the presence of the haplotype does not indicate the presence or absence of a specific phenotype, but rather the degree to which the phenotype occurs, e.g., on the PANSS scale; as one example, alleles of the marker rs11030008 can impact the severity of delusions and suspiciousness/persecution not necessarily its presence or absence of these symptoms.

In methods where the haplotype analysis is performed to predict response to a particular treatment, the sharing of a haplotype (e.g., of some or all of the marker alleles) between the test haplotype and a reference haplotype is indicative of how the subject is likely to respond to the treatment. For example, the reference haplotype can be from a relative, e.g., a first or second degree relative, or from an unrelated individual (or population), that has been diagnosed with SZ and further identified as responding positively (i.e., with an improvement in one or more symptoms of the disease) or negatively (i.e., with no improvement, or even a worsening, of one or more symptoms of the disease, or with excessive side effects).

In some embodiments, the methods include administering a treatment to a subject identified as being at increased risk for developing SZ, e.g., a pharmacological treatment as described herein. In some embodiments, the subject has no overt or clinical signs of SZ, SD, or SPD, and the treatment is administrated before any such signs appear.

Information obtained using a method described herein can be used, e.g., to select a subject population for a clinical trial, to stratify a subject population in a clinical trial, and/or to stratify subjects that respond to a treatment from those who do not respond to a treatment, or subjects that have negative side effects from those who do not.

In another aspect, the invention provides methods for selecting a subject for inclusion in a clinical trial, e.g., a trial of a treatment for SZ, SD, or SPD. The methods include obtaining a haplotype for the subject including at least one marker that is found within the region delimited by SNP1 and SNP2, inclusive, for a given gene as specified in Table A, or comprising one or more of the exemplary SNP markers for each gene, as specified in the Table B and/or SNP markers in linkage disequilibrium with these markers e.g. as shown in the Examples; determining whether the haplotype is associated with an increased risk of developing SZ; and including the subject in the trial or excluding the subject from the trial if the haplotype indicates that the subject has altered drug response for patients with SZ, SD, or SPD.

In another aspect, the invention provides methods for selecting a subject for administration of a treatment for schizophrenia (SZ). The methods include obtaining a haplotype for the subject, wherein the haplotype comprises at least one marker that is listed in Table B, or is in linkage disequilibrium with a marker listed in Table B, as exemplified by the Markers listed in Table C; determining whether the haplotype is associated with altered (e.g., positive or negative) treatment response for patients with SZ; and administering the treatment to the subject if the haplotype indicates that the subject has an improved response to the treatment. In another aspect, the invention provides methods for selecting a treatment for administration to a subject. The methods include obtaining a haplotype for the subject, wherein the haplotype comprises at least one marker that is listed in Table B, or is in linkage disequilibrium unit with a marker listed in Table B; determining whether the haplotype is associated with altered (e.g., positive or negative) treatment response for patients with schizophrenia (SZ); and administering the treatment for SZ to the subject if the haplotype indicates that the subject has an improved response to the treatment.

In another aspect, the invention provides methods for evaluating the effect of a haplotype on the outcome of a treatment for schizophrenia (SZ). The methods include obtaining information regarding outcome of the treatment, wherein the information comprises a parameter relating to the treatment of each subject in a population of subjects; obtaining haplotypes for each subject in the population, wherein the haplotype comprises at least one marker that is listed in Table B, or is in linkage disequilibrium with a marker listed in Table B; and correlating the information regarding outcome with the haplotypes; thereby evaluating the effect of the haplotype on the outcome of the treatment.

In some embodiments, the method includes selecting a treatment for administration to a subject who has a selected haplotype, based on the effect of the haplotype on the outcome of the treatment.

In some embodiments, the information regarding outcome of the treatment is from a completed clinical trial, and the analysis is retrospective.

In a further aspect, the invention features methods for detecting the presence of a haplotype associated with susceptibility to SZ (broadly defined as including, in addition to narrowly defined SZ, SD or SPD) in a subject, by analyzing a sample of DNA from the subject.

Additionally, the invention features methods of predicting a test subject's risk of developing SZ. The methods include obtaining a reference haplotype of a reference subject, wherein the reference subject has SZ, SD, or SPD; determining a test haplotype of the test subject in the same region; and comparing the test haplotype to the reference haplotype, wherein the sharing of a haplotype in this region between the test subject and the reference subject is an indication of an increased likelihood that the test subject will develop SZ. In some embodiments, the method further includes comparing the subject's haplotype to a reference subject who does not have SZ, SD, or SPD.

Further, the invention features methods for predicting a test subject's risk of developing SZ. The methods include obtaining a reference haplotype of a reference subject in a region described herein, wherein the reference subject has SZ; obtaining a test haplotype of the test subject in the same region; and comparing the test haplotype to the reference haplotype. The sharing of a haplotype in this region between the test subject and the reference subject is an indication of an increased likelihood that the test subject will develop SZ. In some embodiments, the method also includes comparing the test subject's haplotype to a reference subject who does not have SZ.

Also provided herein are kits for use in detection of haplotypes associated with SZ, including at least one nucleic acid probe that hybridizes to a sequence that includes a polymorphism described herein, or can be used to amplify a sequence that includes a polymorphism described herein.

Also provided are arrays that include a substrate having a plurality of addressable areas, wherein one or more of the addressable areas includes one or more probes that can be used to detect a polymorphism described herein.

In another aspect, the invention provides methods for providing information regarding a subject's risk of developing schizophrenia (SZ). The methods include obtaining a sample from the subject at a first site; transferring the sample to a second site for analysis, wherein the analysis provides data regarding the identity, presence or absence of at least one test marker that is that is found within the region delimited by SNP1 and SNP2, inclusive, for a given gene as specified in Table A, or comprising one or more of the exemplary SNP markers for each gene, as specified in the Examples and/or SNP markers in linkage disequilibrium with these markers; and transferring the data to one or more of a health care provider, the subject, or a healthcare payer. In some embodiments, the first site is a health care provider's place of business, or is not a health care provider's place of business, e.g., the subject's home.

In some embodiments, the data is transferred to a healthcare payer and used to decide whether to reimburse a health care provider.

Definitions

As defined herein, “Schizophrenia” or “SZ” includes the SZ-spectrum disorders, Schizotypal Personality Disorder (SPD) and Schizoaffective Disorder (SD), as well as Schizophrenia under the narrower, DSM-IV definition (see below).

As used herein, a “haplotype” is one or a set of signature genetic changes (polymorphisms) that are normally grouped closely together on the DNA strand, and are usually inherited as a group; the polymorphisms are also referred to herein as “markers.” A “haplotype” as used herein is information regarding the presence or absence of one or more contiguous genetic markers on a given chromosome in a subject. A haplotype can consist of a variety of genetic markers, including indels (insertions or deletions of the DNA at particular locations on the chromosome); single nucleotide polymorphisms (SNPs) in which a particular nucleotide is changed; microsatellites; and minisatellites.

Microsatellites (sometimes referred to as a variable number of tandem repeats or VNTRs) are short segments of DNA that have a repeated sequence, usually about 2 to 5 nucleotides long (e.g., CACACA), that tend to occur in non-coding DNA. Changes in the microsatellites sometimes occur during the genetic recombination of sexual reproduction, increasing or decreasing the number of repeats found at an allele, changing the length of the allele. Microsatellite markers are stable, polymorphic, easily analyzed and occur regularly throughout the genome, making them especially suitable for genetic analysis.

“Linkage disequilibrium” occurs when the observed frequencies of associations of alleles for different polymorphisms in a population do not agree with frequencies predicted by multiplying together the allele frequencies for the individual genetic markers, thus resulting in a specific haplotype in the population.

The term “chromosome” as used herein refers to a gene carrier of a cell that is derived from chromatin and comprises DNA and protein components (e.g., histones). The conventional internationally recognized individual human genome chromosome numbering identification system is employed herein. The size of an individual chromosome can vary from one type to another with a given multi-chromosomal genome and from one genome to another. In the case of the human genome, the entire DNA mass of a given chromosome is usually greater than about 100,000,000 base pairs. For example, the size of the entire human genome is about 3×10⁹ base pairs.

The term “gene” refers to a DNA sequence in a chromosome that codes for a product (either RNA or its translation product, a polypeptide). A gene contains a coding region and includes regions preceding and following the coding region (termed respectively “leader” and “trailer”). The coding region is comprised of a plurality of coding segments (“exons”) and intervening sequences (“introns”) between individual coding segments.

The term “probe” refers to an oligonucleotide. A probe can be single stranded at the time of hybridization to a target. As used herein, probes include primers, i.e., oligonucleotides that can be used to prime a reaction, e.g., a PCR reaction.

The term “label” or “label containing moiety” refers in a moiety capable of detection, such as a radioactive isotope or group containing same, and nonisotopic labels, such as enzymes, biotin, avidin, streptavidin, digoxygenin, luminescent agents, dyes, haptens, and the like. Luminescent agents, depending upon the source of exciting energy, can be classified as radioluminescent, chemiluminescent, bioluminescent, and photoluminescent (including fluorescent and phosphorescent). A probe described herein can be bound, e.g., chemically bound to label-containing moieties or can be suitable to be so bound. The probe can be directly or indirectly labeled.

The term “direct label probe” (or “directly labeled probe”) refers to a nucleic acid probe whose label after hybrid formation with a target is detectable without further reactive processing of hybrid. The term “indirect label probe” (or “indirectly labeled probe”) refers to a nucleic acid probe whose label after hybrid formation with a target is further reacted in subsequent processing with one or more reagents to associate therewith one or more moieties that finally result in a detectable entity.

The terms “target,” “DNA target,” or “DNA target region” refers to a nucleotide sequence that occurs at a specific chromosomal location. Each such sequence or portion is preferably at least partially, single stranded (e.g., denatured) at the time of hybridization. When the target nucleotide sequences are located only in a single region or fraction of a given chromosome, the term “target region” is sometimes used. Targets for hybridization can be derived from specimens which include, but are not limited to, chromosomes or regions of chromosomes in normal, diseased or malignant human cells, either interphase or at any state of meiosis or mitosis, and either extracted or derived from living or postmortem tissues, organs or fluids; germinal cells including sperm and egg cells, or cells from zygotes, fetuses, or embryos, or chorionic or amniotic cells, or cells from any other germinating body; cells grown in vitro, from either long-term or short-term culture, and either normal, immortalized or transformed; inter- or intraspecific hybrids of different types of cells or differentiation states of these cells; individual chromosomes or portions of chromosomes, or translocated, deleted or other damaged chromosomes, isolated by any of a number of means known to those with skill in the art, including libraries of such chromosomes cloned and propagated in prokaryotic or other cloning vectors, or amplified in vitro by means well known to those with skill; or any forensic material, including but not limited to blood, or other samples.

The term “hybrid” refers to the product of a hybridization procedure between a probe and a target.

The term “hybridizing conditions” has general reference to the combinations of conditions that are employable in a given hybridization procedure to produce hybrids, such conditions typically involving controlled temperature, liquid phase, and contact between a probe (or probe composition) and a target. Conveniently and preferably, at least one denaturation step precedes a step wherein a probe or probe composition is contacted with a target. Guidance for performing hybridization reactions can be found in Ausubel et al., Current Protocols in Molecular Biology, John Wiley & Sons, N.Y. (2003), 6.3.1-6.3.6. Aqueous and nonaqueous methods are described in that reference and either can be used. Hybridization conditions referred to herein are a 50% formamide, 2×SSC wash for 10 minutes at 45° C. followed by a 2×SSC wash for 10 minutes at 37° C.

Calculations of “identity” between two sequences can be performed as follows. The sequences are aligned for optimal comparison purposes (e.g., gaps can be introduced in one or both of a first and a second nucleic acid sequence for optimal alignment and non-identical sequences can be disregarded for comparison purposes). The length of a sequence aligned for comparison purposes is at least 30%, e.g., at least 40%, 50%, 60%, 70%, 80%, 90% or 100%, of the length of the reference sequence. The nucleotides at corresponding nucleotide positions are then compared. When a position in the first sequence is occupied by the same nucleotide as the corresponding position in the second sequence, then the molecules are identical at that position. The percent identity between the two sequences is a function of the number of identical positions shared by the sequences, taking into account the number of gaps, and the length of each gap, which need to be introduced for optimal alignment of the two sequences.

The comparison of sequences and determination of percent identity between two sequences can be accomplished using a mathematical algorithm. In some embodiments, the percent identity between two nucleotide sequences is determined using the GAP program in the GCG software package, using a Blossum 62 scoring matrix with a gap penalty of 12, a gap extend penalty of 4, and a frameshift gap penalty of 5.

As used herein, the term “substantially identical” is used to refer to a first nucleotide sequence that contains a sufficient number of identical nucleotides to a second nucleotide sequence such that the first and second nucleotide sequences have similar activities. Nucleotide sequences that are substantially identical are at least 80%, e.g., 85%, 90%, 95%, 97% or more, identical.

The term “nonspecific binding DNA” refers to DNA which is complementary to DNA segments of a probe, which DNA occurs in at least one other position in a genome, outside of a selected chromosomal target region within that genome. An example of nonspecific binding DNA comprises a class of DNA repeated segments whose members commonly occur in more than one chromosome or chromosome region. Such common repetitive segments tend to hybridize to a greater extent than other DNA segments that are present in probe composition.

As used herein, the term “stratification” refers to the creation of a distinction between subjects on the basis of a characteristic or characteristics of the subjects. Generally, in the context of clinical trials, the distinction is used to distinguish responses or effects in different sets of patients distinguished according to the stratification parameters. In some embodiments, stratification includes distinction of subject groups based on the presence or absence of particular markers or haplotypes described herein. The stratification can be performed, e.g., in the course of analysis, or can be used in creation of distinct groups or in other ways.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Methods and materials are described herein for use in the present invention; other, suitable methods and materials known in the art can also be used. The materials, methods, and examples are illustrative only and not intended to be limiting. All publications, patent applications, patents, sequences, database entries, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control.

Other features and advantages of the invention will be apparent from the following detailed description and figures, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A-C is a list of exemplary genes useful in the methods described herein, with the sequence identifiers from the GenBank database for their genomic sequences.

DETAILED DESCRIPTION

The present inventors have used bioinformatics and genetic linkages for related neuropsychiatric endophenotypes and DSM disease definitions to define genes in common cellular pathways across various chromosomes as high priority targets for TDT and Case/Control analysis. Resources of the International HapMap project (hapmap.org) were used to define SNPs in these loci, whose pattern of transmission in families and disease association in the population captures extant genetic variation (including important coding variation if present) contributing to genetic susceptibility to SZ-spectrum disorders.

The invention includes methods for assessing genetic risk, aiding in diagnosis, and/or stratifying patient populations in order to select optimal treatments based on evaluation of single nucleotide polymorphisms (SNPs) for a number of bioinformatically identified genes on chromosomes 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, and/or 20 relating to SZ-spectrum disorders including narrowly defined schizophrenia, schizotypal personality disorder (SPD) and schizoaffective disorder (SD) (collectively referred to herein as “SZ”). Specific SNPs delimiting each gene (delimiting SNPs) are given along with exemplary SNPs can be used to capture significant haplotype variation in these genes. Important variants can be verified via TDT using families with multiple affected individuals (such as those collected CCGS) and by Case/Control comparisons using the SNP markers presented herein. Using SNP markers lying between the delimiting SNPs, inclusive, and identical to or in linkage disequilibrium with the exemplary SNPs, one can determine the haplotypes in these genes relating to genetic risk of developing SZ-spectrum disorders via family-based association analyses. These haplotypes can then be used to determine risk of developing these disorders by Case/Control studies. The allelic and genotypic variants thus identified can be used for assessing genetic risk, to aid in diagnosis, and/or to stratify patient population in order to select optimal treatments (atypical antipsychotic, typical antipsychotic, and/or psychosocial intervention) for patients.

Methods of Evaluating Susceptibility to SZ, Pharmacological Response, and Psychiatric Endophenotypes

Described herein are a variety of methods for the determination of a subject's risk of developing SZ (which can also be considered susceptibility to SZ) and related clinical phenotypes, likelihood or risk of having an specific endophenotype or severity of an endophenotype, and for predicting a subject's response to a treatment for SZ.

“Susceptibility” to SZ does not necessarily mean that the subject will develop SZ, but rather that the subject is, in a statistical sense, more likely to develop SZ than an average member of the population, i.e., has an increased risk of developing SZ. As used herein, susceptibility to SZ exists if the subject has a haplotype associated with an increased risk of SZ as described herein. Ascertaining whether the subject has such a haplotype is included in the concept of diagnosing susceptibility to SZ as used herein. Similarly, susceptibility to displaying a particular clinical phenotype does not mean that the subject will have the phenotype, but rather that the subject is, in a statistical sense, more likely to display the phenotype. Thus, the methods described herein can include obtaining a haplotype associated with an increased risk of having a specific clinical phenotype as described herein for the subject. Furthermore, a prediction of response may not provide 100% certainty, but simply a statistical likelihood that the subject will respond in a particular way to a particular treatment. Such determinations are useful, for example, for purposes of diagnosis, treatment selection, and genetic counseling.

As used herein, “obtaining a haplotype” includes obtaining information regarding the identity, presence or absence of one or more genetic markers in a subject. Obtaining a haplotype can, but need not, include obtaining a sample comprising DNA from a subject, and/or assessing the identity, presence or absence of one or more genetic markers in the sample. The individual or organization who obtains the haplotype need not actually carry out the physical analysis of a sample from a subject; the haplotype can include information obtained by analysis of the sample by a third party. Thus the methods can include steps that occur at more than one site. For example, a sample can be obtained from a subject at a first site, such as at a health care provider, or at the subject's home in the case of a self-testing kit. The sample can be analyzed at the same or a second site, e.g., at a laboratory or other testing facility. Obtaining a haplotype can also include or consist of reviewing a subject's medical history, where the medical history includes information regarding the identity, presence or absence of one or more genetic markers in the subject, e.g., results of a genetic test.

As described herein, haplotypes associated with SZ include specific alleles for markers in Tables B and C, and makers in linkage disequilibrium with these, as exemplified by the Case/Control results in Table 1.

As one example, haplotypes associated with pharmacological response include one or more markers in Tables B and C and/or markers in linkage disequilibrium with these markers as exemplified by the Examples in Tables 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 and 13. Haplotypes associated with response to olanzapine can include one or more markers listed in Tables 2 and 3 and/or markers in linkage disequilibrium with these markers. Haplotypes associated with response to risperidone can include one or more markers listed in Tables 4 and 5 and/or markers linkage disequilibrium with these markers. Haplotypes associated with response to quetiapine can include one or more markers listed in Tables 6 and 7 and/or markers linkage disequilibrium with these markers. Haplotypes associated with response to perphenazine can include one or more markers listed in Tables 8 and 9 and/or markers linkage disequilibrium with these markers. Haplotypes associated with response to ziprasidone can include one or more markers listed in Tables 10 and 11 and/or markers linkage disequilibrium with these markers. Haplotypes associated with response to antipsychotic medications, as a group, can include one or more markers listed in Tables 12 and 13 and/or markers linkage disequilibrium with these markers. In some embodiments, the haplotype includes one or more of the markers listed in Tables 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 and 13.

As another example, haplotypes associated with specific psychiatric endophenotypes include one or more markers in Tables B and C and/or markers in linkage disequilibrium with these markers as exemplified by the Examples in Tables 14 and 15 and/or markers linkage disequilibrium with these markers. Haplotypes associated with altered scores for the main subscales of the Positive and Negative Syndrome Scale (PANSS) can include one or more markers listed in Table 14. Haplotypes associated with altered scores for specific subscales of the PANSS can include one or more markers listed in Table 15 and/or markers in linkage disequilibrium with these markers. In some embodiments, the haplotype includes one or more of the markers listed in Tables 14 and 15.

In some embodiments, to detect the presence of a haplotype described herein, a biological sample that includes nucleated cells (such as blood, a cheek swab or mouthwash) is prepared and analyzed for the presence or absence of preselected markers. Such diagnoses may be performed by diagnostic laboratories, or, alternatively, diagnostic kits can be manufactured and sold to health care providers or to private individuals for self-diagnosis. Diagnostic or prognostic tests can be performed as described herein or using well known techniques, such as described in U.S. Pat. No. 5,800,998.

Results of these tests, and optionally interpretive information, can be returned to the subject, the health care provider or to a third party payor. The results can be used in a number of ways. The information can be, e.g., communicated to the tested subject, e.g., with a prognosis and optionally interpretive materials that help the subject understand the test results and prognosis. The information can be used, e.g., by a health care provider, to determine whether to administer a specific drug, or whether a subject should be assigned to a specific category, e.g., a category associated with a specific disease endophenotype, or with drug response or non-response. The information can be used, e.g., by a third party payor such as a healthcare payer (e.g., insurance company or HMO) or other agency, to determine whether or not to reimburse a health care provider for services to the subject, or whether to approve the provision of services to the subject. For example, the healthcare payer may decide to reimburse a health care provider for treatments for SZ, SPD, or SD if the subject has an increased risk of developing SZ. As another example, a drug or treatment may be indicated for individuals with a certain haplotype, and the insurance company would only reimburse the health care provider (or the insured individual) for prescription or purchase of the drug if the insured individual has that haplotype. The presence or absence of the haplotype in a patient may be ascertained by using any of the methods described herein.

Information obtained from the methods described herein can also be used to select or stratify subjects for a clinical trial. For example, the presence of a selected haplotype described herein can be used to select a subject for a trial. The information can optionally be correlated with clinical information about the subject, e.g., diagnostic, therapeutic, or endophenotypic information.

Haplotypes Associated with SZ, Pharmacological Response, and Psychiatric Endophenotypes

The methods described herein include the analysis of genotypic information for exemplary SNPs described herein as being associated with increased risk of developing SZ, pharmacological response, and having specific psychiatric endophenotypes. The methods can also (or alternatively) include the evaluation of SNPs that are in linkage disequilibrium with the exemplary SNPs (as one of skill in the art will appreciate, those SNPs that are in linkage disequilibrium will provide essentially the same information as the exemplary SNPs). In some embodiments, the methods include the use of SNPs that are in linkage disequilibrium and are within a specified region of the gene. Table B includes exemplary delimiting SNPs and exemplary test SNPs that can be used in capturing significant haplotype variation in these genes. Although exemplary delimiting SNPs are provided, in some embodiments the region can be delimited by one of the other SNPs listed herein, e.g., an exemplary test SNP that is in LD with the primary SNP. In some embodiments, the specific region of the gene is between and excluding the delimiting SNPs; in some embodiments, the specific region is between and including the delimiting SNPs.

TABLE B Delimiting and Exemplary SNPs for Novel SZ Genes Gene CHR Delimiting SNPs Exemplary SNPS Potassium Channel and Related Genes KCNC4 1 rs1359149 to rs11578913 rs615204, rs34171476, rs35167146 KCNA10 1 rs1281177 to rs17025957 rs1281175, rs34970857, rs1281174, rs3768456 KCND3 1 rs197422 to rs10745323 rs12033257, rs35027371, rs3738298, rs11102342, rs4838924, rs4839183, rs17215423, rs2289723, rs3820673, rs1936061 KCNH1 1 rs12126648 to rs1538287 rs3135473, rs1135317, rs1770213, rs1770220, rs11119627, rs1501569, rs1393026, rs11119658, rs4620600, rs4578265, rs867848, ANK3 10 rs1050745 to rs1551684 rs1049862, rs7911953, rs2393607, rs12261793, rs10733757, rs7907721, rs4568956, rs2241540, rs2393596, rs11596260, rs3750800, rs10218875, rs4948254, rs6479694 KCNQ1 11 rs11022827 to rs2239897 rs2283155, rs6578273, rs34320941, rs4930127, rs2283174, rs45478697, rs45606931, rs45497392, rs231348, rs17215465, rs760419, rs231899, rs63934, rs45603932, rs1057128, rs81205, rs45594640, rs34516117, rs1800172, rs34150427, rs11601907, rs8234 KCNC1 11 rs7949069 to rs1236205 rs2299637, rs4757587, rs757514, rs10766434, rs7942518 Cell Adhesion and Related Genes RP1-21O18.1 1 rs9663010 to rs2235789 rs7546786, rs6663699, rs1316257, rs938249, rs6674129, rs2073091, rs2076563, rs12057431, rs4661572 CTNND1 11 rs558653 to rs652908 rs2156638, rs11570176, rs10896644, rs11570194, rs483030, rs11570199, rs612688, rs11570222, rs708228 DACT1 14 rs464582 to rs160472 rs167481, rs150722, rs167481, rs863091, , rs34015825, rs17832998, rs17094821, rs698025, rs11541 CDH11 16 rs35148 to rs7204464 rs35147, rs35145978, rs35144, rs35229, rs35213, rs4424934, rs35195, rs35186, rs1520233, rs7188625 Vesicle Related Genes VAMP4 1 rs10913508 to rs7556644 rs15655, rs15655, rs10913530, rs2073484, rs6672082, rs12096984 SYT14 1 rs9429830 to rs11119426 rs227221, rs4844923, rs2205989, rs11119392, rs227227, rs2307890, rs11119415, rs17188183, rs4609425 BRSK2 11 rs7395835 to rs1554857 rs10833086, rs7932863, rs9651643, rs34893167, rs1881504, rs11029039, rs3829225, rs1574122 SYT13 11 rs2863172 to rs11038382 rs4992029, rs8929, rs2863174, rs4755941, rs7103871, rs12362429, rs2863182 STX2 12 rs2632601 to rs7962097 rs6486602, rs1236, rs4759517, rs2277336, rs6486600, rs4759794, rs7301926, rs6486602, rs10848210, rs10848210 RTN1 14 rs17255975 to rs7144589 rs7161094, rs1950785, rs4898998, rs12717467, rs34431036, rs35707243, rs35645652, rs35645652, rs35864480, rs10145080, rs17310036 UNC13C 15 rs11071015 to rs9920150 rs17731958, rs2115827, rs2163195, rs12594549, rs1897069, rs12910912, rs12910912, rs11856476, rs4776216, rs7183952, rs12917364, rs12914912, rs8035356, rs1158075, rs1849210, rs12913366, rs489526, rs8025195, rs16974691, rs9302181, rs11639005, rs1520411, rs9920139 SV2B 15 rs11630131 to rs7169918 rs2073967, rs35575298, rs8027498, rs1075840, rs16945475, rs2301665, rs3743444, rs1117388, rs1117388, rs16945529 Genes Related to Glutamate Pathways Gcom1 15 rs1908202 to rs1808478 rs4774275, rs1908206, rs2470357, rs2069133, ,rs16977629, rs16977631, rs986868, rs2733617, rs16977644, rs2733619, rs2470361, rs11854917 GRINL1A 15 rs1908202 to rs1808478 rs4774275, rs1908206, rs2470357, rs2069133, , rs16977629, rs16977631, rs986868, rs2733617, rs16977644, rs2733619, rs2470361, rs11854917 GOT2 16 rs2042445 to rs4238801 rs30839, rs6993, rs30842, rs11076256, rs257636, rs257620 G-Protein-Coupled Receptor Genes RHOG 11 rs1055640 to rs4406820 rs1451722, rs17173879, rs1049388, rs1451719, rs11030008 GPR135 14 rs17255731 to rs4898989 rs1612112, rs1253181, rs10138199, rs9323348, rs1752427, rs1752428, rs10136708 AKAP13 15 rs1533124 to rs11637212 rs16977252, rs8024200, rs7180213, rs6497206, rs2291049, rs2061821, U171, rs2061822, rs34434221, rs2061824, rs745191, rs7177107, rs7177107, rs4075256, rs4075254, rs4843074, rs4843075, rs7162168, rs4842895, rs35079107, rs338523, rs338556, rs11073502, rs11073502, rs2241268, rs2241268, rs1053992 Delimiting SNPs for Hormone, Inositol, and Diacylglyceride Related Genes HSD17B12 11 rs12364003 to rs11037691 rs4573669, rs10838160, rs4755744, rs7129046, rs3802891, rs11555762, rs1061810 TMEM55B 14 rs1130409 to rs1760941 rs17112002, rs1760943, rs35567022 IGF1R 15 rs35554027 to rs702497 rs8028620, rs7170035, rs7174918, rs8038015, rs4966020, rs4965436, rs8030950, rs1879613, rs11247380, rs45445894, rs34516635, rs33958176, , rs33958176, rs45553041, rs2684808, rs3743262, rs1546713, rs2229765, rs2684792, rs17847203, rs3833015 Cytoskeletal, Myosin, Actin and Microtubulal Related Genes EVL 14 rs1190954 to rs35257667 rs748354, rs1190956, rs1190974, rs3206354, rs726514, rs941897, rs34073270, rs4905933 KATNAL2 18 rs9304340 to rs1434528 rs2576042, rs2187092, rs2571030, rs2247221, rs7233515, rs9961383, rs2289130 Genes for Carrier Proteins and Transporters SLC6A17 1 rs924181 to rs545849 rs877068, rs1010892, rs6689641, rs534276, rs534276, rs6685009, rs12133992 SLC16A4 1 rs10857820 to rs12127781 rs2946571, rs11120, rs6673423, rs2271885, rs35157487, rs3738750, rs1334882, rs884684 SLC6A5 11 rs894747 to rs1401793 rs2001982, rs2241940, rs1443547, rs7109418, rs1443548, rs34243519, rs894750, rs4923386, rs16906566, rs11827415, rs3740870, rs1805091, rs7944684, rs2298826, rs2276433, rs16906628, rs1401793 SLC17A6 11 rs1155821 to rs2593644 rs2246710, rs11026523, rs2078352, rs11026532, rs1900586, rs764021, rs7117340, rs1979072, rs1979073 SLCO3A1 15 rs11858120 to rs1060206 rs12907294, rs4294800, rs2176452, rs12912997, rs1878556, rs2286355, rs1517618, rs6496893, rs2074887, rs2302085, rs8174 Cell Cycle and Tumor Suppressor/Promoter Related Genes RERE 1 rs1055236 to rs914994 rs8627, rs1058766, rs13596, rs3753275, rs7530745, rs12136689, rs7532459, rs7554486, rs6698830 FASLG 1 rs763110 to rs12135884 rs929087, rs6700734, rs10458360, rs35178418 DEAF1 11 rs936465 to rs6597990 rs11822917, rs34114147, rs7109335, rs10902188, rs6597996, rs34094369, rs7935419, rs7121608, rs4963145 HCCA2 11 rs12786504 to rs2334652 rs7945160, rs9440, rs10219175, rs7396514, rs7945160, rs10742185 PTPN5 11 rs873670 to rs7932938 rs7946105, rs1550871, rs1550870, rs6483524, rs4757707, rs10766500, rs4272766, rs4274187, rs4345940 CHFR 12 rs1531822 to rs3741494 rs3741489, rs3741492, rs2306536, rs2306537, rs9634239, rs2306541, rs4758954, rs35206714, rs34220055, rs2291253, rs11147144 TTC5 14 rs10130942 to rs10873395 rs10147548, rs3737220, rs1953552, rs3742945, rs34675160, rs2318864 FUSSEL18 18 rs2137289 to rs892583 rs7236105, rs17785419, rs10502880, rs2668771 SMAD2 18 rs1792666 to rs2000709 rs7228393, rs1792682, rs17340985, rs1787176, rs1942158, rs12457664 SMAD7 18 rs9944944 to rs736839 rs11874392, rs8088297, rs34151545, rs11874392, rs1873190, rs3736242 SMAD4 18 rs620898 to rs12456284 rs3764465, rs12958604, rs2276163, rs12458752, rs2298617 Genes Involved in Neuronal Development and Plasticity DNM3 1 rs6701033 to rs13932 rs965051, rs2206543, rs7554526, rs2093184, rs3736790, rs10489730, rs3736791, rs3736791, rs4576686, rs4075021, rs4382763, rs34870740, rs9425287, rs2301454, rs10752946, rs7528296 TOLLIP 11 rs5744038 to rs5743854 rs3750920, rs3168046, rs35365323, rs5744015, rs5743899 DUSP8 11 rs6578504 to rs10734456 rs3740620, rs2008493, rs7934037, rs3740620, rs3740620, rs902224, rs902225 NAV2 11 rs890136 to rs2246192 rs2278132, rs2042600, rs10766590, rs7119267, rs6483617, rs16937196, rs2585788, rs11025310, rs7935182, rs16937251, rs1372989, rs10833202, rs11025335, rs12284679, rs2707084, rs6483629, rs3802799, rs3802800, rs7125647, rs1442710, rs1867114, rs2028570, rs2289566, rs35891966, rs3802803 LRRC4C 11 rs11035693 to rs10128639 rs998447, rs2953310, rs1551833, rs6485187, rs10837367, rs998447, rs3802787 RTN4RL2 11 rs2729363 to rs2955849 rs2511986, rs3851117 DTX4 11 rs10896947 to rs544864 rs6591507, rs6591507, rs656163, rs2211912, rs621162, rs1048444, rs3847, rs5029315 ULK1 12 rs11246867 to rs7978708 rs3088051, rs9652059, rs11616018, rs12303764, rs11609348, rs3088051, rs3088051 NDRG2 14 rs1263871 to rs1243451 rs10196, rs1243444, rs1243446, rs1243446, rs1243450, rs10138807 JPH4 14 rs12897422 to rs222732 rs11844366, rs10149510, rs10149510, rs10150089 DAAM1 14 rs17095965 to rs4127823 rs17095965, rs17833769, rs1252989, rs1268579, rs4901909, rs1253005, rs4898983, rs10143918, rs12147707, rs8022614, rs941884, rs1958180, rs941886, rs11626926, rs10083442 NEDD4 15 rs4424863 to rs1509408 rs3088077, rs17238461, rs8028559, rs34478706, rs12232351, rs2303579, rs2303580, rs1912402, rs16976618, rs2271289, rs1553739, rs11632974 RGMA 15 rs12438714 to rs4114 rs2272453, rs13167, rs1997382, rs2091635, rs6497019 N4BP1 16 rs9937623 to rs9936446 rs3826176, rs1224, rs1039342, rs3826176, rs1120276, rs2354580 NDRG4 16 rs7202037 to rs2280397 rs13333449, rs2042405, rs2271948, rs2271948, rs42945, rs1058132 CDH8 16 rs4131634 to rs9302540 rs16963768, rs16963771, rs4636897, rs9922048, rs11862141, rs6498807, rs9939991, rs1369918, rs1978796, rs11075445, rs1397131, rs8057338 BEAN 16 rs6499082 to rs12445633 rs11644279, rs34695237, rs4247350 KIAA0513 16 rs1875246 to rs1466864 rs7499978, rs3803637, rs4783121, rs12597135, rs12446708, rs3794684, rs3751756 DYM 18 rs1288812 to rs17725481 rs833503, rs357894, rs8096141, rs8092003, rs2276200, rs523373, rs498929, rs35435872, rs10775493, rs1943675 DCC 18 rs17753970 to rs2270954 49311296, rs11875475, rs1145245, rs1465943, rs6508145, rs8089980, rs13381333, rs1893572, rs1431748, rs2229080, rs950278, rs8096519, rs7506904, rs12457407, rs4940251, rs8097413, rs2278339, rs1393331, rs984274, rs984274, rs6508235 BMP7 20 rs6014947 to rs2208404 rs162316, rs10375, rs3787381, rs230198, rs193044, rs6025469 TMEPAI 20 rs6025689 to rs6015068 rs6025698, rs427278, rs13043471, rs4811905 Calcium/Calmodulin Related Genes CAMTA1 1 rs449250 to rs228651 rs10864639, rs12044121, rs6688732, rs6577393, rs7554752, rs6577401, rs12070592, rs2067995, rs845197, rs1193219, rs1011124, rs6696544, rs12751990, rs3737907, rs3737906, rs4908473, rs1417986, rs2071986, rs707455 CACNA1E 1 rs541886 to rs635118 rs553042, rs17494681, rs506947, rs3856090, rs199960, rs3766980, rs35606457, rs35737760, rs34488539, rs4652678, rs199930, rs704326, rs638132 CAMK1G 1 rs17014820 to rs926387 rs2356933, rs6690557, rs9430004, rs35618105, rs11119314, rs11119315, rs2272879, rs2206107, rs4140599, rs2076230 RIMBP2 12 rs1496858 to rs7963990 rs10848094, rs756186, rs749093, rs11060869, rs7303240, rs2277356, rs2292663, rs2292664, rs7952756, rs2277361, rs871568, rs4237817, rs4759708 Genes Involved in Hereditary Hearing Loss DPH3 3 rs2292614 to rs2245708 rs859703, rs842257, rs2245721, rs2245708 EXOC2 6 rs10900954 to rs13205146 rs11242914, rs12952, rs4072107, rs1473909, rs2493037, rs2064302, rs2277095, rs2493049, rs2294660, rs2294664, rs998777, rs35600069, rs17756886, rs1747599, rs2039713 USH1C 11 rs4756895 to rs2073582 rs2237965, rs1055577, rs1055574, rs2072225, rs1064074, rs34077456, rs10832796, rs16770, rs10766408, rs2240487, rs35336155, rs2041027, rs2237957 OTOG 11 rs2073582 to rs11024358 rs10766410, rs11823045, rs7130190, rs11024323, rs7112749, rs7106548, rs4757548, rs2355466, rs11024333, rs7936324, rs7936354, rs11024335, rs2041028, rs1003490, rs7111528, rs11024350, rs12422210, rs10832824, rs2023483, rs11024357 SERGEF 11 rs1236205 to rs1133758 rs10788, rs1528, rs4757589, rs2237930, rs211146, rs2283233, rs211130, rs172424, rs211137, rs34960078, rs2237908 EML1 14 rs10140193 to rs7149272 rs10144785, rs7143905, rs12433613, rs11160553, rs6575751, rs746698, rs7144394, rs2273707, rs34198557, rs2250718, rs2273704, rs11160563 PMP22 17 rs230938 to rs179521 rs231018, rs13422, rs7215851, rs231021 Genes Encoding Zinc-Finger Proteins PRDM2 1 rs2487657 to rs979932 rs1203682, rs1203677, rs2076324, rs17350795, rs1203648 ZFP91-CNTF 11 rs1944055 to rs4319530 rs1938596, rs948562, rs7945889, rs8373, rs1938596, rs11229545 ZNF423 16 rs193907 to rs12443775 rs729805, rs1344529, rs2287314, rs12597210, rs16947716, rs34611339, rs34214571, rs34214571, rs12924119, rs2292155, rs10852603, rs8060387 Brain-Expressed Genes Not Otherwise Specified PER3 1 rs172933 to rs707472 rs2797685, rs707463, rs707465, rs35426314, rs228669, rs17031601, rs10462020, rs35604043, rs35687686, rs35899625, rs228697, rs2640909, rs10462021 RABGAP1L 1 rs6681627 to rs12126129 rs6425302, rs6425305, rs16847624 PHACS 11 rs178512 to rs2285029 rs16937817, rs2074038, rs33952257, rs2018795, rs178521, rs35514614, rs2074043, rs7950395, rs178529, rs3107275 YPEL4 11 rs1798177 to rs1647394 rs7947357, rs890036, rs12793139, rs7947357, rs12294735 KIAA1853 12 rs7979864 to rs722307 rs1568923, rs6490226, rs1405049, rs4766926, rs7134748, rs7969288, rs10849629, rs12422371, rs7297606, rs7136574, rs2723880, rs2723882, rs2555269, rs1541764 KIAA1545 12 rs10870551 to rs7294615 rs36098511, rs7137911, rs2323991, rs4883568, rs4883556, rs3751315, rs10870472, rs4883513, rs11208 TEP1 14 rs1713418 to rs1760890 rs2104978, rs938886, rs1713449, rs34811735, rs35929175, rs35165628, rs7150689, rs34895824, rs2297615, rs35517499, rs938887, rs34401320, rs1713456, rs1713457, rs2229100, rs1760904, rs2228041, rs1713458, rs1760903, rs34179031, rs17111188, rs2228035, rs34770935, rs1760898, rs1760897 WDR25 14 rs2273802 to rs10151709 , rs2273801, , , rs34007610, rs34331240, rs2273800, rs3742387, rs941924, rs4905966, rs10873518, rs4905969, rs4905969 BEGAIN 14 rs11628965 to rs7140556 rs11845025, rs12893951, rs35286207, rs4073549, rs4074037, rs6575793 HERC2 15 rs7495174 to rs1614575 rs1129038, rs11074322, rs11636232, rs1133496, rs1133496, rs4073541, rs2238289, rs3940272, rs11631797, rs916977, rs1635168, rs1635163 ADAM10 15 rs3764196 to rs514049 rs6494032, rs12592750, rs7166076, rs8039791, rs12899638, rs7165402, rs12912286, rs4775086, rs2054096, rs653765 KLHL25 15 rs11637212 to rs7181017 rs2614676, rs2554, rs3743335, rs2430838, rs36031133, rs35582838, rs11073537, rs2002909, rs2946365 NETO2 16 rs1551188 to rs7184206 rs16952126, rs16952126, rs9923731, rs11859615, rs3095622 CBLN1 16 rs3743777 to rs9935379 rs11076478, rs1510977, rs1437105 KIAA0182 16 rs4240810 to rs3815795 rs35869664, rs3815794, rs736845, rs2303203, rs9940601, rs1049868 C16orf74 16 rs11644122 to rs301143 rs373835, rs2305357, rs386061, rs408988 COX10 17 rs4792434 to rs7218697 rs2302107, rs16948978, rs34342426, rs16948986, rs8077302, rs2159132, rs8070339, rs2230354, rs11078233 KIAA0427 18 rs1039989 to rs752151 rs2175565, rs7229395, rs2306514, rs2277712, rs8094634, rs10853569, rs8095199, rs1038308, rs4939813, rs3764481, rs937021 Additionally, a number of exemplary SNPs in linkage disequilibrium with the SNPs in Table B were evaluated for impact on SZ risk, pharmacological response, and specific psychiatric phenotypes (endophenotypes). These exemplary SNPs in linkage disequilibrium with those in Table B are listed in Table C.

TABLE C Exemplary SNPs in Linkage Disequilibrium with Table B SNPs Gene SNPs in linkage disequilibrium with those in Table B ADAM10 rs7164844, rs7161889, rs605928 AKAP13 rs12440599, rs2291048, rs2241268, rs16949988, rs2430838, rs870689, rs2241269, rs2241266, rs8025135, rs10520596, rs16941653, rs17623915, rs745191 ANK3 rs11596260, rs10761451, rs10761446, rs1551683, rs2393602, rs1078534, rs1050745 BEAN rs11075635, rs1063438 BMP7 rs6123669, rs6127980, rs162313, rs230191, rs230198 BRSK2 rs1108991, rs1554857, rs7396009 C16orf74 rs442069, rs394623, rs386061, rs11644122 CACNA1E rs17494681, rs16857457, rs678643, rs553042, rs7513540, rs3856093, rs10797729, rs7554158, rs1953690, rs7534913, rs704331, rs17693196, rs546191 CAMK1G rs10489339, rs7516885, rs9429821, rs713075, rs7512091, rs6683256 CAMTA1 rs1616122, rs277675, rs17030082, rs845265, rs2097518, rs9919223, rs707463, rs697686, rs2301488, rs10864255, rs2071918, rs9434833, rs6698901, rs4908575, rs6657847, rs11121029, rs4243823 CBLN1 rs9935379, rs12598711, rs1469906, rs893175 CDH11 rs35216, rs35195, rs35186, rs35144, rs40115, rs35140, rs4625747, rs35164, rs35162, rs35165, rs4967886 CDH8 rs11075445, rs1397126, rs13336134, rs9302540, rs9925201, rs7189354, rs4784163, rs6498806, rs4416006, rs16964164, rs11641508, rs11862752 CHFR rs4758911, rs11147101, rs7297261 COX10 rs8077302, rs1003060 CTNND1 rs1786438 DAAM1 rs7143953, rs10873113, rs8004164, rs10483710, rs1271513, rs941886, rs4901909, rs12590850, rs1958180, rs1547199, rs12589351, rs4901921, rs2053298, rs1957409, rs6573250, rs2099636, rs17096088 DACT1 rs863091 DCC rs1031062, rs882333, rs4998815, rs12967277, rs7228674, rs9954344, rs7506909, rs2270954, rs9949949, rs11082964, rs2036415, rs8089980, rs9966074, rs10515959, rs17504520, rs11876282, rs1502229, rs4940259, rs12605899, rs17506154, rs8088048, rs16954731, rs7504750, rs9953016, rs9807201, rs10853622, rs10853621, rs12455180, rs10502969 DEAF1 rs10902190, rs936465, rs7123677 DNM3 rs6690848, rs9425606, rs9425598, rs4072117, rs12410416, rs12075807, rs10910966, rs7540873, rs1063412, rs6701929, rs7550558, rs2586389, rs2586392, rs10158839 DPH3 rs842252, rs842264, rs842261, rs2470508, rs842251, rs842259, rs842254 DTX4 rs2211912, rs3847, rs544864 DUSP8 rs1554857, rs7396009, rs1108991, rs10734456 DYM rs577979, rs7239949, rs357894, rs16950298 EML1 rs8013843, rs12435250, rs3818279, rs4900447, rs11160554, rs1957509, rs1191109, rs11623084, rs17099031, rs10150225, rs10131519, rs1005766, rs8020741, rs2250718, rs12590861, rs975252, rs11850280, rs3783322 EVL rs1190967, rs10148930, rs2400848, rs10136836, rs12431406 EXOC2 rs12154040, rs2073008, rs1150856, rs9405242, rs2473484, rs17135931 FASLG rs10458360 FUSSEL18 rs2164098, rs11877471, rs8086549, rs9304344, rs9965170, rs11082575, rs11663646, rs17785419, rs7244178 GCOM1 rs2470360, rs1873993, rs9302201, rs1425948, rs9806498, rs16977629, rs7176042, rs11638184, rs11071337 GPR135 rs1253103, rs2774052, rs4898989, rs1273156, rs1253170 GRINL1A rs2470360, rs9302201, rs11071337, rs9806498, rs7176042, rs11638184, rs1873995, rs16977629, rs1873993 HCCA2 rs7396009, rs1554857, rs1108991, rs10734456 HERC2 rs8041209, rs2346050, rs6497292, rs916977, rs6497272 HSD17B12 rs7482725, rs10838166, rs10768983, rs11037691, rs10838186, rs17596617, rs10838184, rs938942, rs7116641 IGF1R rs1879613, rs4966012, rs11633717, rs1879612, rs1521481, rs7165181, rs11634874, rs4966036, rs951715, rs7173377, rs3743258 KATNAL2 rs2010834, rs4986203, rs2571034, rs2576040 KCNA10 rs1281177 KCNC1 rs10766426, rs2299637 KCND3 rs584096, rs1373291, rs544941, rs197412 KCNH1 rs10863854, rs1777264, rs1340127, rs1777256, rs1875438, rs7529770, rs4951495, rs11119679, rs1501555, rs7546472 KCNQ1 rs2283179 KIAA0182 rs1053328, rs9940601, rs732460, rs736845 KIAA0427 rs2337099, rs12458062, rs1384227, rs1023943, rs12456253, rs9952398, rs8083702, rs1994559, rs937021 KIAA0513 rs3794682, rs8063083, rs715707 KIAA1545 rs4242909 KIAA1853 rs4298970, rs4767783, rs1541764, rs4075945, rs7966721, rs1568922, rs10851061, rs7298478 KLHL25 rs870689, rs17623915, rs10520595, rs11637212, rs8025135, rs2241266, rs2430838 LRRC4C rs2953310, rs10501227, rs10501225, rs1377106 N4BP1 rs8046716, rs2129243 NAV2 rs10732471, rs2255677, rs2119981, rs12099330, rs2625312, rs1867116, rs11025328, rs1982265, rs1559665, rs10500860, rs7119267 NDRG2 rs1243446 NDRG4 rs1058132, rs16960170, rs40359 NEDD4 rs11630780, rs4520787, rs9972348, rs12916104, rs10518831, rs1509408, rs2175104 NETO2 rs9928466 OTOG rs734640, rs869108, rs11024348, rs2237959, rs972676, rs10766410, rs4757560, rs757982, rs7111528, rs11024357 PER3 rs697686, rs707463, rs228688, rs228652 PHACS rs7950395, rs3134907 PMP22 rs231020, rs230915, rs192046, rs2323653, rs10852830, rs230911, rs11656487 PTPN5 rs7117716, rs4757718, rs4075664, rs755796, rs11024782, rs7950091, rs11024786 RABGAP1L rs1793319, rs10912854 RERE rs4581300, rs6577499, rs12024032, rs10779702 RHOG rs11030008, rs1869002, rs1055640 RIMBP2 rs4759462, rs1877978 RP1-21O18.1 rs761288, rs4501834, rs1000313, rs4661563, rs6665012, rs10803343 RTN1 rs1957311, rs17731838, rs1884737, rs12878097, rs17256003, rs1951366 SERGEF rs4141243, rs11024415, rs2299628, rs2283233, rs4757589 SLC16A4 rs3768458 SLC17A6 rs1562445, rs2078352, rs11026546, rs721840 SLC6A17 rs17671169, rs6689641, rs2784140, rs1571346 SLC6A5 rs16906507 SLCO3A1 rs8027160, rs975721, rs12905912, rs11630872, rs207954, rs8032981 SMAD2 rs10502890, rs1792670 SMAD4 rs7243135, rs1789223 SMAD7 rs2337153, rs12953717 STX2 rs10848205, rs7956851 SV2B rs1117387, rs1002556, rs11631712, rs6496778, rs17516708, rs2269799, rs1079535, rs6496780, rs2106692, rs11630131, rs2239994 SYT13 rs7943596, rs1075778, rs1077491, rs6485608, rs7118408, rs7124508, rs12362444, rs4755941, rs7117240 SYT14 rs6701631, rs7543650, rs12029138 TEP1 rs1760909, rs1713448, rs1713449, rs1713419 TOLLIP rs2672812, rs2014486 TTC5 rs2318864, rs11623837, rs4981148, rs4981951, rs8022565, rs4981948 ULK1 rs10794440 UNC13C rs8023723, rs500853, rs8025195, rs573320, rs12912762, rs934192, rs7163424, rs8024165, rs12917023, rs16974712, rs12900128, rs1961635, rs1864416, rs2115820, rs8024845, rs2115825, rs12148800, rs1897069, rs9920150, rs17731958 USH1C rs4756895, rs1076311, rs2237961, rs2041032, rs972676, rs1064074, rs10766410, rs2237959 VAMP4 rs9943293, rs10913529 WDR25 rs11160589, rs7492607 YPEL4 rs1798173 ZFP91-CNTF rs2509920, rs948562 ZNF423 rs4785185

Identification of Additional Markers by Linkage Disequilibrium Analysis

Linkage disequilibrium (LD) is a measure of the degree of association between alleles in a population. One of skill in the art will appreciate that haplotypes involving markers in LD with the polymorphisms described herein can also be used in a similar manner to those described herein. Methods of calculating LD are known in the art (see, e.g., Morton et al., Proc Natl Acad Sci USA 98(9):5217-21 (2001); Tapper et al., Proc Natl Acad Sci USA 102(33):11835-11839 (2005); Maniatis et al., Proc Natl Acad Sci USA 99:2228-2233 (2002)).

Thus, in some embodiments, the methods include analysis of polymorphisms that are in LD with a polymorphism described herein. Methods are known in the art for identifying such polymorphisms; for example, the International HapMap Project provides a public database that can be used, see hapmap.org, as well as The International HapMap Consortium, Nature 426:789-796 (2003), and The International HapMap Consortium, Nature 437:1299-1320 (2005). Generally, it will be desirable to use a HapMap constructed using data from individuals who share ethnicity with the subject, e.g., a HapMap for African Americans would ideally be used to identify markers in LD with an exemplary marker described herein for use in genotyping a subject of African American descent.

Alternatively, methods described herein can include analysis of polymorphisms that show a correlation coefficient (r²) of value ≧0.5 with the markers described herein. Results can be obtained, e.g., from on line public resources such as HapMap.org. The correlation coefficient is a measure of LD, and reflects the degree to which alleles at two loci (for example two SNPs) occur together, such that an allele at one SNP position can predict the correlated allele at a second SNP position, in the case where r² is >0.

Incorporation of Additional Haplotypes Associated with SZ, Pharmacological Response, and Psychiatric Endophenotypes

In some embodiments, the methods described herein can include determining the presence of a haplotype that includes one or more additional polymorphisms associated with SZ, pharmacological response, and psychiatric endophenotypes.

By way of example, numerous studies have implicated various phosphatidylinositol kinases in SZ, including PIP5K2A (Bakker et al., Genes Brain Behav. 6:113-119 (2007)) and PI3K via interaction with AKT (Kalkman, Pharmacol. Ther. 110:117-134 (2006)). The use of variants in the PI4K2B gene in SZ diagnosis and pharmacogenomics has been described, see, e.g., International Patent Application No. PCT/US2007/078399. Additionally, insulin and diacylglycerol interact with the inositol pathways. As described herein, combining such findings with protein-protein interaction data, pathway analyses, and the large literature on genetic linkage studies for neuropsychiatric illnesses, has allowed the present inventors to identify a number of inositol, insulin and diacylglycerol genes that can be used for SZ risk assessment, diagnosis and pharmacogenomics.

As a second example, potassium channels and potassium current signaling molecules interact with many pathways including dopamine signaling pathways (Canavier et al., J. Neurophysiol. 98:3006-3022 (2007)). The potassium channel gene KCNIP4 has been implicated in schizophrenia risk, see, e.g., International Patent Application No. PCT/US2007/078399. Other groups have reported the possible involvement of KCNN3 polymorphisms in SZ (Ivkovic et al., Int. J. Neurosci. 116:157-164 (2006). As described herein, several additional potassium channel genes, as well as genes that produce proteins that interact with potassium pathways, have been identified that are predicted to play a role in SZ risk and/or drug response.

In some embodiments, the methods described herein can include determining the presence of a haplotype that includes one or more polymorphisms near D22S526 and/or the polymorphisms in the Sult4a1 gene and/or polymorphisms within 1 LDU of these markers, e.g., as described in U.S. Pat. Pub. No. 2006-0177851, incorporated herein in its entirety.

In some embodiments, the methods described herein can include determining the presence of a haplotype that includes one or more polymorphisms in the PI4K2B gene and/or polymorphisms in the KCNIP4 gene and/or polymorphisms in the CERK gene and/or polymorphisms in the SHANK3 gene and/or polymorphisms within 1 LDU of these markers, e.g., as described in International Pat. Application No. PCT/US2007/078399 and US Pat. Pub. No. 2009-0012371, incorporated herein in its entirety.

In some embodiments, the methods described herein can include determining the presence of a haplotype that includes one or more polymorphisms in the HPCAL1 gene and/or the polymorphisms in the SV2C gene and/or polymorphisms in linkage disequilibrium with these markers, e.g., as described in International Pat. Application No. PCT/US2008/088061, incorporated herein in its entirety.

In some embodiments, the methods include determining the presence of a haplotype that includes one or more polymorphisms in the novel SZ-spectrum genes and/or the polymorphisms in linkage disequilibrium with specific markers in these genes, e.g., as described in PCT/US2009/030057, incorporated herein in its entirety.

Identification of Additional Markers for Use in the Methods Described Herein

In general, genetic markers can be identified using any of a number of methods well known in the art. For example, numerous polymorphisms in the regions described herein are known to exist and are available in public databases, which can be searched using methods and algorithms known in the art. Alternately, polymorphisms can be identified by sequencing either genomic DNA or cDNA in the region in which it is desired to find a polymorphism. According to one approach, primers are designed to amplify such a region, and DNA from a subject is obtained and amplified. The DNA is sequenced, and the sequence (referred to as a “subject sequence” or “test sequence”) is compared with a reference sequence, which can represent the “normal” or “wild type” sequence, or the “affected” sequence. In some embodiments, a reference sequence can be from, for example, the human draft genome sequence, publicly available in various databases, or a sequence deposited in a database such as GenBank. In some embodiments, the reference sequence is a composite of ethnically diverse individuals.

In general, if sequencing reveals a difference between the sequenced region and the reference sequence, a polymorphism has been identified. The fact that a difference in nucleotide sequence is identified at a particular site that determines that a polymorphism exists at that site. In most instances, particularly in the case of SNPs, only two polymorphic variants will exist at any location. However, in the case of SNPs, up to four variants may exist since there are four naturally occurring nucleotides in DNA. Other polymorphisms, such as insertions and deletions, may have more than four alleles.

Other Genetic Markers of Schizophrenia

The methods described herein can also include determining the presence or absence of other markers known or suspected to be associated with SZ, or with SD, or SPD, e.g., markers outside of a region identified herein, see, e.g., Harrison and Owen, Lancet, 361(9355):417-419 (2003), including, for example, markers on chromosome 22 and other chromosomes, e.g., in the region of 22q12.3 (e.g., near D22S283), 22q11.2, 22q11.2, 22q11-q13, 1q42.1, 1q42.1, 1q21-q22, 2p, 2q, 3p25, 4p, 4q, 5q11.2-q13.3, 6p22.3, 6p23, 6q13-q26, 7q, 8p12-21, 8q, 9p, 10p15-p13 (e.g., near D105189), 10q22.3, 11q14-q21, 12q24, 13q34, 13q32, 14q32.3, 15q15, 16p, 17q, 18p, 18q, 19p. 20p, 21q, Xq, and/or the X/Y pseudoautosomal region. In some embodiments, the methods include determining the presence or absence of one or more other markers that are or may be associated with SZ, or with SZ, SD or SPD, e.g., in one or more genes, e.g., ACE (Illi et al., Eur Neuropsychopharmacol 13:147-151 (2003)); ADRA1A (Clark et al., Biol Psychiatry. 58(6):435-9 (2005)); ADH1B (Xu et al., Mol Psychiatry. 9(5):510-21 (2004); Vawter et al., Hum Genet. 119(5):558-70 (2006)); AHI1 (Eur J Hum Genet. 14(10):1111-9 (2006)); AKT1 (Emamian et al., Nature Genet. 36:131-137 (2004)); ALDH3B1 (Sun et al. Sci. China C. Life. Sci. 48(3):263-9 (2005)); ALK (Kunagi et al., J Neural Transm. 113(10):1569-73 (2006)); APC (Cui et al., Mol Psychiatry (7):669-77 (2005)); APOE (Liu et al., Schizophr Res 62: 225-230 (2003)); ARSA (Marcao et al., Mol Genet Metab. 79(4):305-7 (2003); ARVCF (Chen et al., Schizophr Res. 72(2-3):275-7 (2005)); ATXN1 (Pujana et al Hum Genet 99:772-775 (1997); Joo et al., Psychiatr Genet 9:7-11 (1999); Fallin et al., Am J Hum Genet 77:918-936 (2005)); BDNF (Neves-Pereira et al., Molec. Psychiat. 10:208-212 (2005)); BRD1 (Severinsen et al., Mol Psychiatry. 11(12):1126-38 (2006)); BZRP (Kurumaji et al., J Neural Transm. 107(4):491-500 (2000)); DAO (Owen et al., Trends Genet. 21(9):518-25 (2005)); DAOA (Owen et al., 2005, supra); CAPON (Brzustowicz et al., Am J Hum Genet. 74(5):1057-63 (2004)); CCKAR (Zhang et al., Mol Psychiatry 5:239-240 (2000); Sanjuan et al., Eur Psychiatry 19:349-353 (2004)); CHGB (Kitao et al., Psychiatr Genet 10:139-143 (2000); Zhang et al., Neurosci Lett 323:229-233 (2002)); CHI3L1 (Zhao et al., Am J Hum Genet. 80(1):12-8 (2007)); CHRNA2 (Blaveri et al., Europ. J. Hum. Genet. 9: 469-472 (2001)); CHRNA7 (Leonard et al. Arch Gen Psychiatry. 2002 59:1085-1096 (2002); De Luca et al. Neuropsychobiology. 50:124-127 (2004)); CLDNS (Sun et al., Eur Psychiatry 19:354-357 (2004); Wei and Hemmings, Prostaglandins Leukot Essent Fatty Acids 73(6)4:41-445 (2005)); COMT (Shifman et al., Am. J. Hum. Genet. 71:1296-1302 (2002)); CNR1 (Ujike et al., Mol Psychiatry 7:515-518 (2002)); CPLX2 (Lee et al., Behav Brain Funct. 1:15 (2005)); DGCR8 (Jacquet et al., Hum Mol Genet. 11(19):2243-9 (2002)); DISC1 (Owen et al., 2005, supra; see, e.g., the D1S2709 marker (Ekelend et al., Hum. Molec. Genet. 10:1611-1617 (2001), DDR1 (Roig et al., Mol Psychiatry. 12(9); 833-41 (2007); DRD4 (Lung et al., Schizophr Res 57:239-245 (2002)); DDR3 (Williams et al., Mol Psychiatry 3:141-149 (1998)); DRD5 (Williams et al., Psychiatr Genet 7:83-85 (1997); Muir et al., Am J Med Genet 105:152-158 (2001)); HEP3 haplotype, Hennah et al., Hum. Molec. Genet. 12: 3151-3159 (2003), and Leu607Pro, Hodgkinson et al., Am. J. Hum. Genet. 75:862-872 (2004), Erratum: Am. J. Hum. Genet. 76:196 (2005)); DISC2 (Millar et al., Ann Med. 36(5):367-78 (2004)); DPYSL2 (Hong et al., Am J Med Genet B Neuropsychiatr Genet. 136(1):8-11 (2005)); DRD1 (Coon et al., Am. J. Hum. Genet. 52: 327-334 (1993)); DRD2 (Glatt et al., Am. J. Psychiat. 160:469-476 (2003)); DRD3 (Rybakowski et al., Molec. Psychiat. 6:718-724 (2001)); DTNBP1 (Owen et al., 2005, supra); EGR3 (Yamada et al., Proc Natl Acad Sci 104(8):2815-20 (2007)); EPSIN4 (Am J Hum Genet. 76(5):902-7 (2005)); ErbB; EGF (Futamura et al., Am. J. Hum. Genet. 52: 327-334 (2002)); ENTH (Pimm et al., Am J Hum Genet 76:902-907 (2005); Tang et al., Mol Psychiatry 11:395-399 (2006)); ERBB4 (Norton et al., Am J Med Genet B Neuropsychiatr Genet 14; 11; 96-101 (2005); Silberberg et al., Am J Med Genet B Neuropsychiatr Genet 141B; 2; 142-148 (2006)); FEZ1 (Yamada et al., Biol Psychiatry 56:683-690(2004)); FOXP2 (Sanjuan et al., Psychiatr Genet. 16(2):67-72 (2006)); FXYD6 (Choudhury et al., Am J Hum Genet. 80(4):664-72 (2007)); FZD3 (Katsu et al., Neurosci Lett 353:53-56 (2003); Yang et al., Biol Psychiatry 54:1298-1301 (2003); Zhang et al., Am J Med Genet 129B:16-19 (2004)); GABRA1, GABRA2, GABRA6, GABRP (Petryshen et al., Mol Psychiatry. 10(12):1057 (2005)); GABBR1 (Zai et al. Eur Neuropsychopharmacol. 15:347-52 (2005); Le-Niculescu et al. Am J Med Genet B Neuropsychiatr Genet. 144:129-58 (2007)); GAD1 (Addington et al., Mol Psychiatry 10:581-588(2005)); GFRA1 (Semba et al., Brain Res Mol Brain Res. 124(1):88-95 (2004)); GCLM (Tosic et al., Am J Hum Genet. 79(3):586-92 (2006)); GNB3 (Kunugi et al., J. Neural Transm. 109(2):213-8 (2002)); GPR78 (Underwood et al., Mol Psychiatry. 11(4):384-94 (2006)); GRIA1 (Magri et al., Am J Med Genet B Neuropsychiatr Genet 141(3):287-93 (2006)); GNPAT (Lin et al., Biol Psychiatry. 60(6):554-62 (2006)); GRID1 (Fallin et al., Am J Hum Genet 77:918-936(2005)); GRIK1 (Shibata et al., Psychiatr Genet. 11(3):139-44 (2001)); GRIK2 (Shibata et al., Psychiatry Res. 113(1-2):59-67 (2002)); GRIK3 (Shibata et al., Psychiatry Res. 30: 141(1): 39-51 (2006)); GRIK4 (Pikard et al., Mol Psychiatry 11(9):847-57(2006)); GRIN1 (Qin et al., Eur J Hum Genet. 13(7):807-14 (2005)); GRIN2A, GRIN2B (Abdolmaleky et al., Am J Pharmacogenomics. 5(3):149-60 (2005)); GRIN2D (Makino et al., Psychiatr Genet. 15(3):215-21 (2005)); GRM3 (Egan et al., Proc Natl Acad Sci USA. 101(34):12604-9 (2004)); GRM4 (Ohtsuki et al., Psychiatr Genet. 11(2):79-83 (2001)); GRM5 (Devon et al., Mol Psychiatry. 6(3):311-4 (2001)); GSTM1 (Harada et al., Biochem Biophys Res Commun 281:267-271 (2001); Pae et al., Psychiatr Genet 14:147-150 (2004)); G30/G72 (Schulze et al., Am J Psychiatry. 162(11):2101-8 (2005)); HTR2A (Baritaki et al., Eur J Hum Genet. 12(7):535-41 (2004)); HLA-DRB1 (Schwab et al., Am J Med Genet. 114(3):315-20 (2002)); HLA-BRB3 (Yu et al., Zhonghua Liu Xing Bing Xue Za Zhi. 24(9):815-8 (2003)); HTRSA (Abdolmaleky et al., Schizophr Res 67:53-62 (2004)); HTR6 (Tsai et al., Neurosci Lett. 271(2):135-7 (1999)); IL1B (Katila et al., Mol Psychiatry 4:179-181(1999); Meisenzahal et al., Am J Psychiatry 158:1316-1319 (2001); Zanardini et al., J Psychiatr Res 37:457-462 (2003)); IL1RN (Zanardini et al., J Psychiatr Res 37:457-462 (2003); Kim et al., Psychiatr Genet 14:165-167 (2004); Papiol et al., Neuroimage 27:1002-1006 (2005)); IL10 (Chiavetto et al., Biol Psychiatry 51:480-484 (2002); Jun et al., Psychiatry Clin Neurosci 56:177-180 (2002)); IL2RB (Schwab et al., Am J Med Genet. 60(5):436-43 (1995)); KCNN3 (Ujike et al., Psychiatry Res. 101(3):203-7 (2001)); KIF13A (Jamain et al., Genomics. 74(1):36-44 (2001)); KIF2A (Li et al., Neurosci Letters 407(2) 151-5 (2006)); KPNA3 (Wei and Hemmings, Neurosci Res. 52(4):342-6 (2005)); LGI1 (Fallin et al. A J Hum Genet. 77:918-36 (2005)); MAG (Wan et al., Neurosci Lett. 388(3):126-31 (2005)); MAOA (Jonsson et al., Schizophr Res 61:31-37 (2003); Wei and Hemmings. Psychiatr Genet 9, 177-181 (1999)); MED12 (Sandhu et al., Am J Med Genet B Neuropsychiatr Genet. 123B: 33-38 (2003); Spinks et al., Am J Med Genet B Neuropsychiatr Genet. 127B:20-27 (2004)); MLC1 (Verma et al., Biol Psychiatry. 58(1):16-22 (2005)); MTHFR (Lewis et al., Am. J. Med. Genet. (Neuropsychiat. Genet.) 135B:2-4 (2005)); MTR (Kempisty et al., Psychiatr Genet. 17(3):177-81 (2007)); MTHFD1 (Kempisty et al., Psychiatr Genet. 17(3):177-81 (2007)); NCAM1 (Sullivan et al., Biol Psychiatry. 61(7):902-10 (2007)); NDE1 (Hennah et al., Hum Mol Genet. 16(5):453-62 (2006)); NDUFV2 (Waskizuka et al., Am J Med Genet B Neuropsychiatr Genet. 141(3):301-4 (2006)); NOS1 (Liou et al., Schizophr Res. 65(1):57-9 (2003)); NOTCH4 (Wei and Hemmings, (Letter) Nature Genet. 25:376-377 (2000)); NPAS3 (Kamnasaran et al., J Med Genet 40:325-332 (2003)); NRG1 (Owen et al., 2005, supra); NRG3 (Fallin et al. A J Hum Genet. 77:918-36 (2005)); NTNG1 (Fukawasa et al., J Med Dent Sci 51:121-128 (2004); Aoki-Suzuki et al., Biol Psychiatry 57:382-393 (2005)); NTNG2 (Aoki-Suzuki et al., Biol Psychiatry 57:382-393 (2005)); NTF3 (Jonsson et al., Acta Psychiatr Scand 95:414-419 (1997)); OLIG2 (Georgieva et al., Proc Natl Acad Sci 103(33):12469-74 (2006)); PCQAP (Sandhu et al., Psychiatr Genet. 14(3):169-72 (2004)); PDE4B (Millar et al., Science 310:1187-1191 (2005)); PDLIMS (Horiuchi et al., Biol Psychiatry 59(5):434-9 (2005)); PICK1 (Hong et al., Neuroreport 15:1965-1967 (2004); Fujii et al., Molecular Psychiatry 11:150-157 (2005)); PIK3C3 (Stopkova et al., Biol Psychiatry 55:981-988 (2004); Duan et al., Neurosci Lett., 379:32-36 (2005)); PIK4CA (Saito et al., Am J Med Genet B Neuropsychiatr Genet. 116(1):77-83 (2003)); PIP5K2A (Stopkova et al., Psychiatr Genet. 15(3): 223-7 (2005)); PLA2G4A, PLA2G4C (Yu et al., Prostaglandins Leukot Essent Fatty Acids. 73(5):351-4 (2005)); PLA2G4B (Tao et al., Am J Med Genet B Neuropsychiatr Genet 137:56-58 (2005)); PLXNA2 (Mah et al., Molecular Psychiatry 11:471-478 (2006)); PTGS2 (Wei and Hemmings. Prostaglandins Leukot Essent Fatty Acids 70:413-415 (2004)); PPP3CC (Gerber et al., Proc Natl Acad Sci USA. 100(15):8993-8 (2003)); PNOC (Blaveri et al., 2001); PRODH (Chakravarti, Proc. Nat. Acad. Sci. 99:4755-4756 (2002)); QKI (Aberg et al., Am J Med Genet B Neuropsychiatr Genet. 2005 Dec. 9; [Epub ahead of print]); RGS4 (Chowdari et al., Hum. Molec. Genet. 11:1373-1380 (2002), Erratum: Hum. Molec. Genet. 12:1781 (2003)); RELN (Costa et al., Mol Interv. 2(1):47-57 (2002)); RTN4 (Novak et al., Brain Res Mol Brain Res 107:183-189 (2002); Tan et al., Brain Res Mol Brain Res 139:212-216 (2005)); SCA1 (Culkjovic et al., Am J Med Genet. 96(6):884-7 (2000)); SLC15A1 (Maheshwari et al., BMC Genomics. 3(1):30 (2002)); SLC18A1 (Bly, Schizophr Res. 78(2-3):337-8 (2005)); SLC18A2 (Gutierrez et al. Am J Med Genet B Neuropsychiatr Genet. 144(4):502-7 (2007)); SLC6A4 (Fan and Sklar, Mol Psychiatry. 10(10):928-38, 891 (2005)); SNAP29 (Saito et al., Mol Psychiatry 6(2):193-201 (2001); Erratum in: Mol Psychiatry 6(5):605 (2001); SULT4A1 (Brennan and Chondra. Am J Med Genet B Neuropsychiatr Genet. 139(1):69-72 (2005)); SYNGR1 (Verma et al., Biol Psychiatry. 55(2):196-9 (2004)); SYN2 (Chen et al., Bio. Psychiat. 56:177-181 (2004)); SYN3 (Porton et al. Biol Psychiatry. 55(2):118-25 (2004)); TAAR4 (Duan et al., Am J Hum Genet 75:624-638 (2004)); TBP/SCA17 (Chen et al., Schizophr Res. 78(2-3):131-6 (2005)); TH (Kurumaji et al., J Neural Transm 108:489-495 (2001); Meloni et al., C R Acad Sci III 318:803-809 (1995)); TNFA (Morar et al., Am J Med Genet B Neuropsychiatr Genet. 144(3):318-24 (2007)); TPH1 (Nolan et al., Psychiatr Genet 10:109-115 (2000); Hong et al., Schizophr Res 49:59-63 (2001); Sekizawa et al., Am J Med Genet B Neuropsychiatr Genet 128:24-26 (2004)); TPP2 (Fallin et al. A J Hum Genet. 77:918-36 (2005)); TPS3 (Park et al., Schizophr Res 67:71-74 (2004); Ni et al., Neurosci Lett 388:173-178 (2005)); TRAR4 (Am J Hum Genet. 75(4):624-38 (2004)); TRAX (Thomson et al., Mol Psychiatry. 10(7):657-68, 616 (2005)); UFD1L (De Luca et al., Am J Med Genet. 105(6):529-33 (2001)); UCP2 (Yasuno et al., Am J Med Genet B Neuropsychiatr Genet. 144(2):250-3 (2007)); UCP4 (Yasuno et al.,: Am J Med Genet B Neuropsychiatr Genet. 144(2):250-3 (2007)); UHMK1 (Puri et al., Biol Psychiatry 61(7):873-9 (2007)); XBP1 (Chen et al., Biochem Biophys Res Commun 319:866-870 (2004); Kakiuchi et al., Psychiatry Clin Neurosci 58:438-440 (2004)); YWHAH (Toyooka et al., Am J Med Genet. 88(2):164-7 (1999)); ZDHHC8 (Mukai et al., Nature Genet. 36:725-731 (2004)); or ZNF74 (Takase et al., Schizophr Res. 52(3):161-5 (2001)). See also, e.g., OMIM entry no. 181500 (SCZD).

Methods of Determining the Presence or Absence of a Haplotype Associated with SZ, Pharmacological Response, and Psychiatric Endophenotypes

The methods described herein include determining the presence or absence of haplotypes associated with SZ, pharmacological response, and psychiatric endophenotypes. In some embodiments, an association with SZ is determined by the presence of a shared haplotype between the subject and an affected reference individual, e.g., a first or second-degree relation of the subject, or population of affected individuals, and the absence of the haplotype in an unaffected reference individual. In some embodiments, an association with a pharmacological response is determined by the presence of a shared haplotype between the subject and a reference individual (or population) who had an identified response to a pharmacological treatment. In some embodiments, an association with a specific psychiatric endophenotype is determined by the presence of a shared haplotype between the subject and a reference subject or population with (or without) the specific endophenotype. Thus the methods can also include obtaining and analyzing a sample from a suitable reference individual.

Samples that are suitable for use in the methods described herein contain genetic material, e.g., genomic DNA (gDNA). Non-limiting examples of sources of samples include urine, blood, and tissue. The sample itself will typically consist of nucleated cells (e.g., blood or buccal cells), tissue, etc., removed from the subject. The subject can be an adult, child, fetus, or embryo. In some embodiments, the sample is obtained prenatally, either from a fetus or embryo or from the mother (e.g., from fetal or embryonic cells in the maternal circulation). Methods and reagents are known in the art for obtaining, processing, and analyzing samples. In some embodiments, the sample is obtained with the assistance of a health care provider, e.g., to draw blood. In some embodiments, the sample is obtained without the assistance of a health care provider, e.g., where the sample is obtained non-invasively, such as a sample comprising buccal cells that is obtained using a buccal swab or brush, or a mouthwash sample.

The sample may be further processed before the detecting step. For example, DNA in a cell or tissue sample can be separated from other components of the sample. The sample can be concentrated and/or purified to isolate DNA. Cells can be harvested from a biological sample using standard techniques known in the art. For example, cells can be harvested by centrifuging a cell sample and resuspending the pelleted cells. The cells can be resuspended in a buffered solution such as phosphate-buffered saline (PBS). After centrifuging the cell suspension to obtain a cell pellet, the cells can be lysed to extract DNA, e.g., gDNA. See, e.g., Ausubel et al., 2003, supra. All samples obtained from a subject, including those subjected to any sort of further processing, are considered to be obtained from the subject.

The absence or presence of a haplotype associated with SZ, pharmacological response, and/or psychiatric endophenotypes, as described herein can be determined using methods known in the art, e.g., gel electrophoresis, capillary electrophoresis, size exclusion chromatography, sequencing, and/or arrays to detect the presence or absence of the marker(s) of the haplotype. Amplification of nucleic acids, where desirable, can be accomplished using methods known in the art, e.g., PCR.

Methods of nucleic acid analysis to detect polymorphisms and/or polymorphic variants include, e.g., microarray analysis. Hybridization methods, such as Southern analysis, Northern analysis, or in situ hybridizations, can also be used (see Current Protocols in Molecular Biology, Ausubel, F. et al., eds., John Wiley & Sons 2003). To detect microdeletions, fluorescence in situ hybridization (FISH) using DNA probes that are directed to a putatively deleted region in a chromosome can be used. For example, probes that detect all or a part of a microsatellite marker can be used to detect microdeletions in the region that contains that marker.

Other methods include direct manual sequencing (Church and Gilbert, Proc. Natl. Acad. Sci. USA 81:1991-1995 (1988); Sanger et al., Proc. Natl. Acad. Sci. 74:5463-5467 (1977); Beavis et al. U.S. Pat. No. 5,288,644); automated fluorescent sequencing; single-stranded conformation polymorphism assays (SSCP); clamped denaturing gel electrophoresis (CDGE); two-dimensional gel electrophoresis (2DGE or TDGE); conformational sensitive gel electrophoresis (CSGE); denaturing gradient gel electrophoresis (DGGE) (Sheffield et al., Proc. Natl. Acad. Sci. USA 86:232-236 (1989)), mobility shift analysis (Orita et al., Proc. Natl. Acad. Sci. USA 86:2766-2770 (1989)), restriction enzyme analysis (Flavell et al., Cell 15:25 (1978); Geever et al., Proc. Natl. Acad. Sci. USA 78:5081 (1981)); quantitative real-time PCR (Raca et al., Genet Test 8(4):387-94 (2004)); heteroduplex analysis; chemical mismatch cleavage (CMC) (Cotton et al., Proc. Natl. Acad. Sci. USA 85:4397-4401 (1985)); RNase protection assays (Myers et al., Science 230:1242 (1985)); use of polypeptides that recognize nucleotide mismatches, e.g., E. coli mutS protein; allele-specific PCR, for example. See, e.g., U.S. Patent Publication No. 2004/0014095, to Gerber et al., which is incorporated herein by reference in its entirety. In some embodiments, the methods described herein include determining the sequence of the entire region of the genes listed in Tables A and B e.g. between and including the delimiting SNPs for the particular gene. In some embodiments, the sequence is determined on both strands of DNA.

In order to detect polymorphisms and/or polymorphic variants, it will frequently be desirable to amplify a portion of genomic DNA (gDNA) encompassing the polymorphic site. Such regions can be amplified and isolated by PCR using oligonucleotide primers designed based on genomic and/or cDNA sequences that flank the site. See e.g., PCR Primer: A Laboratory Manual, Dieffenbach and Dveksler, (Eds.); McPherson et al., PCR Basics: From Background to Bench (Springer Verlag, 2000); Mattila et al., Nucleic Acids Res., 19:4967 (1991); Eckert et al., PCR Methods and Applications, 1:17 (1991); PCR (eds. McPherson et al., IRL Press, Oxford); and U.S. Pat. No. 4,683,202. Other amplification methods that may be employed include the ligase chain reaction (LCR) (Wu and Wallace, Genomics, 4:560 (1989), Landegren et al., Science, 241:1077 (1988), transcription amplification (Kwoh et al., Proc. Natl. Acad. Sci. USA, 86:1173 (1989)), self-sustained sequence replication (Guatelli et al., Proc. Nat. Acad. Sci. USA, 87:1874 (1990)), and nucleic acid based sequence amplification (NASBA). Guidelines for selecting primers for PCR amplification are well known in the art. See, e.g., McPherson et al., PCR Basics: From Background to Bench, Springer-Verlag, 2000. A variety of computer programs for designing primers are available, e.g., ‘Oligo’ (National Biosciences, Inc, Plymouth Minn.), MacVector (Kodak/IBI), and the GCG suite of sequence analysis programs (Genetics Computer Group, Madison, Wis. 53711).

In one example, a sample (e.g., a sample comprising genomic DNA), is obtained from a subject. The DNA in the sample is then examined to determine a haplotype as described herein. The haplotype can be determined by any method described herein, e.g., by sequencing or by hybridization of the gene in the genomic DNA, RNA, or cDNA to a nucleic acid probe, e.g., a DNA probe (which includes cDNA and oligonucleotide probes) or an RNA probe. The nucleic acid probe can be designed to specifically or preferentially hybridize with a particular polymorphic variant.

In some embodiments, a peptide nucleic acid (PNA) probe can be used instead of a nucleic acid probe in the hybridization methods described above. PNA is a DNA mimetic with a peptide-like, inorganic backbone, e.g., N-(2-aminoethyl)glycine units, with an organic base (A, G, C, T or U) attached to the glycine nitrogen via a methylene carbonyl linker (see, e.g., Nielsen et al., Bioconjugate Chemistry, The American Chemical Society, 5:1 (1994)). The PNA probe can be designed to specifically hybridize to a nucleic acid comprising a polymorphic variant conferring susceptibility to or indicative of the presence of SZ.

In some embodiments, restriction digest analysis can be used to detect the existence of a polymorphic variant of a polymorphism, if alternate polymorphic variants of the polymorphism result in the creation or elimination of a restriction site. A sample containing genomic DNA is obtained from the individual. Polymerase chain reaction (PCR) can be used to amplify a region comprising the polymorphic site, and restriction fragment length polymorphism analysis is conducted (see Ausubel et al., Current Protocols in Molecular Biology, supra). The digestion pattern of the relevant DNA fragment indicates the presence or absence of a particular polymorphic variant of the polymorphism and is therefore indicative of the presence or absence of susceptibility to SZ.

Sequence analysis can also be used to detect specific polymorphic variants. A sample comprising DNA or RNA is obtained from the subject. PCR or other appropriate methods can be used to amplify a portion encompassing the polymorphic site, if desired. The sequence is then ascertained, using any standard method, and the presence of a polymorphic variant is determined.

Allele-specific oligonucleotides can also be used to detect the presence of a polymorphic variant, e.g., through the use of dot-blot hybridization of amplified oligonucleotides with allele-specific oligonucleotide (ASO) probes (see, for example, Saiki et al., Nature (London) 324:163-166 (1986)). An “allele-specific oligonucleotide” (also referred to herein as an “allele-specific oligonucleotide probe”) is typically an oligonucleotide of approximately 10-50 base pairs, preferably approximately 15-30 base pairs, that specifically hybridizes to a nucleic acid region that contains a polymorphism. An allele-specific oligonucleotide probe that is specific for particular a polymorphism can be prepared using standard methods (see Ausubel et al., Current Protocols in Molecular Biology, supra).

Generally, to determine which of multiple polymorphic variants is present in a subject, a sample comprising DNA is obtained from the individual. PCR can be used to amplify a portion encompassing the polymorphic site. DNA containing the amplified portion may be dot-blotted, using standard methods (see Ausubel et al., Current Protocols in Molecular Biology, supra), and the blot contacted with the oligonucleotide probe. The presence of specific hybridization of the probe to the DNA is then detected. Specific hybridization of an allele-specific oligonucleotide probe (specific for a polymorphic variant indicative of susceptibility to SZ) to DNA from the subject is indicative of susceptibility to SZ.

In some embodiments, fluorescence polarization template-directed dye-terminator incorporation (FP-TDI) is used to determine which of multiple polymorphic variants of a polymorphism is present in a subject (Chen et al., (1999) Genome Research, 9(5):492-498). Rather than involving use of allele-specific probes or primers, this method employs primers that terminate adjacent to a polymorphic site, so that extension of the primer by a single nucleotide results in incorporation of a nucleotide complementary to the polymorphic variant at the polymorphic site.

Real-time pyrophosphate DNA sequencing is yet another approach to detection of polymorphisms and polymorphic variants (Alderborn et al., (2000) Genome Research, 10(8):1249-1258). Additional methods include, for example, PCR amplification in combination with denaturing high performance liquid chromatography (dHPLC) (Underhill, P. A., et al., Genome Research, Vol. 7, No. 10, pp. 996-1005, 1997).

The methods can include determining the genotype of a subject with respect to both copies of the polymorphic site present in the genome. For example, the complete genotype may be characterized as −/−, as −/+, or as +/+, where a minus sign indicates the presence of the reference or wild type sequence at the polymorphic site, and the plus sign indicates the presence of a polymorphic variant other than the reference sequence. If multiple polymorphic variants exist at a site, this can be appropriately indicated by specifying which ones are present in the subject. Any of the detection means described herein can be used to determine the genotype of a subject with respect to one or both copies of the polymorphism present in the subject's genome.

In some embodiments, it is desirable to employ methods that can detect the presence of multiple polymorphisms (e.g., polymorphic variants at a plurality of polymorphic sites) in parallel or substantially simultaneously. Oligonucleotide arrays represent one suitable means for doing so. Other methods, including methods in which reactions (e.g., amplification, hybridization) are performed in individual vessels, e.g., within individual wells of a multi-well plate or other vessel may also be performed so as to detect the presence of multiple polymorphic variants (e.g., polymorphic variants at a plurality of polymorphic sites) in parallel or substantially simultaneously according to certain embodiments of the invention.

Probes

Nucleic acid probes can be used to detect and/or quantify the presence of a particular target nucleic acid sequence within a sample of nucleic acid sequences, e.g., as hybridization probes, or to amplify a particular target sequence within a sample, e.g., as a primer. Probes have a complimentary nucleic acid sequence that selectively hybridizes to the target nucleic acid sequence. In order for a probe to hybridize to a target sequence, the hybridization probe must have sufficient identity with the target sequence, i.e., at least 70%, e.g., 80%, 90%, 95%, 98% or more identity to the target sequence. The probe sequence must also be sufficiently long so that the probe exhibits selectivity for the target sequence over non-target sequences. For example, the probe will be at least 20, e.g., 25, 30, 35, 50, 100, 200, 300, 400, 500, 600, 700, 800, 900 or more, nucleotides in length. In some embodiments, the probes are not more than 30, 50, 100, 200, 300, 500, 750, or 1000 nucleotides in length. Probes are typically about 20 to about 1×10⁶ nucleotides in length. Probes include primers, which generally refers to a single-stranded oligonucleotide probe that can act as a point of initiation of template-directed DNA synthesis using methods such as PCR (polymerase chain reaction), LCR (ligase chain reaction), etc., for amplification of a target sequence.

In some embodiments, the probe is a test probe, e.g., a probe that can be used to detect polymorphisms in a region described herein, e.g., polymorphisms as described herein. In some embodiments, the probe can hybridize to a target sequence within a region delimited by delimiting SNPs, SNP1 and SNP2, inclusive as specified for the particular genes in Tables A and B.

In some embodiments, the probe can bind to another marker sequence associated with SZ as described herein.

Control probes can also be used. For example, a probe that binds a less variable sequence, e.g., repetitive DNA associated with a centromere of a chromosome, can be used as a control. Probes that hybridize with various centromeric DNA and locus-specific DNA are available commercially, for example, from Vysis, Inc. (Downers Grove, Ill.), Molecular Probes, Inc. (Eugene, Oreg.), or from Cytocell (Oxfordshire, UK). Probe sets are available commercially, e.g., from Applied Biosystems, e.g., the Assays-on-Demand SNP kits Alternatively, probes can be synthesized, e.g., chemically or in vitro, or made from chromosomal or genomic DNA through standard techniques. For example, sources of DNA that can be used include genomic DNA, cloned DNA sequences, somatic cell hybrids that contain one, or a part of one, human chromosome along with the normal chromosome complement of the host, and chromosomes purified by flow cytometry or microdissection. The region of interest can be isolated through cloning, or by site-specific amplification via the polymerase chain reaction (PCR). See, for example, Nath and Johnson, Biotechnic. Histochem., 1998, 73(1):6-22, Wheeless et al., Cytometry 1994, 17:319-326, and U.S. Pat. No. 5,491,224.

In some embodiments, the probes are labeled, e.g., by direct labeling, with a fluorophore, an organic molecule that fluoresces after absorbing light of lower wavelength/higher energy. A directly labeled fluorophore allows the probe to be visualized without a secondary detection molecule. After covalently attaching a fluorophore to a nucleotide, the nucleotide can be directly incorporated into the probe with standard techniques such as nick translation, random priming, and PCR labeling. Alternatively, deoxycytidine nucleotides within the probe can be transaminated with a linker. The fluorophore then is covalently attached to the transaminated deoxycytidine nucleotides. See, e.g., U.S. Pat. No. 5,491,224.

Fluorophores of different colors can be chosen such that each probe in a set can be distinctly visualized. For example, a combination of the following fluorophores can be used: 7-amino-4-methylcoumarin-3-acetic acid (AMCA), Texas Red™ (Molecular Probes, Inc., Eugene, Oreg.), 5-(and-6)-carboxy-X-rhodamine, lissamine rhodamine B, 5-(and-6)-carboxyfluorescein, fluorescein-5-isothiocyanate (FITC), 7-diethylaminocoumarin-3-carboxylic acid, tetramethylrhodamine-5-(and-6)-isothiocyanate, 5-(and-6)-carboxytetramethylrhodamine, 7-hydroxycoumarin-3-carboxylic acid, 6-[fluorescein 5-(and-6)-carboxamido]hexanoic acid, N-(4,4-difluoro-5,7-dimethyl-4-bora-3a,4a diaza-3-indacenepropionic acid, eosin-5-isothiocyanate, erythrosin-5-isothiocyanate, and Cascade™ blue acetylazide (Molecular Probes, Inc., Eugene, Oreg.). Fluorescently labeled probes can be viewed with a fluorescence microscope and an appropriate filter for each fluorophore, or by using dual or triple band-pass filter sets to observe multiple fluorophores. See, for example, U.S. Pat. No. 5,776,688. Alternatively, techniques such as flow cytometry can be used to examine the hybridization pattern of the probes. Fluorescence-based arrays are also known in the art.

In other embodiments, the probes can be indirectly labeled with, e.g., biotin or digoxygenin, or labeled with radioactive isotopes such as ³²P and ³H. For example, a probe indirectly labeled with biotin can be detected by avidin conjugated to a detectable marker. For example, avidin can be conjugated to an enzymatic marker such as alkaline phosphatase or horseradish peroxidase. Enzymatic markers can be detected in standard colorimetric reactions using a substrate and/or a catalyst for the enzyme. Catalysts for alkaline phosphatase include 5-bromo-4-chloro-3-indolylphosphate and nitro blue tetrazolium. Diaminobenzoate can be used as a catalyst for horseradish peroxidase.

Oligonucleotide probes that exhibit differential or selective binding to polymorphic sites may readily be designed by one of ordinary skill in the art. For example, an oligonucleotide that is perfectly complementary to a sequence that encompasses a polymorphic site (i.e., a sequence that includes the polymorphic site, within it or at one end) will generally hybridize preferentially to a nucleic acid comprising that sequence, as opposed to a nucleic acid comprising an alternate polymorphic variant.

Arrays and Uses Thereof

In another aspect, the invention features arrays that include a substrate having a plurality of addressable areas, and methods of using them. At least one area of the plurality includes a nucleic acid probe that binds specifically to a sequence comprising a polymorphism listed in Table B, and can be used to detect the absence or presence of said polymorphism, e.g., one or more SNPs, microsatellites, minisatellites, or indels, as described herein, to determine a haplotype. For example, the array can include one or more nucleic acid probes that can be used to detect a polymorphism listed in Table B. In some embodiments, the array further includes at least one area that includes a nucleic acid probe that can be used to specifically detect another marker associated with SZ as described herein. The substrate can be, e.g., a two-dimensional substrate known in the art such as a glass slide, a wafer (e.g., silica or plastic), a mass spectroscopy plate, or a three-dimensional substrate such as a gel pad. In some embodiments, the probes are nucleic acid capture probes.

Methods for generating arrays are known in the art and include, e.g., photolithographic methods (see, e.g., U.S. Pat. Nos. 5,143,854; 5,510,270; and 5,527,681), mechanical methods (e.g., directed-flow methods as described in U.S. Pat. No. 5,384,261), pin-based methods (e.g., as described in U.S. Pat. No. 5,288,514), and bead-based techniques (e.g., as described in PCT US/93/04145). The array typically includes oligonucleotide probes capable of specifically hybridizing to different polymorphic variants. According to the method, a nucleic acid of interest, e.g., a nucleic acid encompassing a polymorphic site, (which is typically amplified) is hybridized with the array and scanned. Hybridization and scanning are generally carried out according to standard methods. See, e.g., Published PCT Application Nos. WO 92/10092 and WO 95/11995, and U.S. Pat. No. 5,424,186. After hybridization and washing, the array is scanned to determine the position on the array to which the nucleic acid hybridizes. The hybridization data obtained from the scan is typically in the form of fluorescence intensities as a function of location on the array.

Arrays can include multiple detection blocks (i.e., multiple groups of probes designed for detection of particular polymorphisms). Such arrays can be used to analyze multiple different polymorphisms. Detection blocks may be grouped within a single array or in multiple, separate arrays so that varying conditions (e.g., conditions optimized for particular polymorphisms) may be used during the hybridization. For example, it may be desirable to provide for the detection of those polymorphisms that fall within G-C rich stretches of a genomic sequence, separately from those falling in A-T rich segments.

Additional description of use of oligonucleotide arrays for detection of polymorphisms can be found, for example, in U.S. Pat. Nos. 5,858,659 and 5,837,832. In addition to oligonucleotide arrays, cDNA arrays may be used similarly in certain embodiments of the invention.

The methods described herein can include providing an array as described herein; contacting the array with a sample, e.g., a portion of genomic DNA that includes at least a portion of human chromosome 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, and/or 20, e.g., a region between delimiting SNPs, SNP1 and SNP2 for each of the genes listed in Tables A and B, and/or optionally, a different portion of genomic DNA, e.g., a portion that includes a different portion of human chromosomes 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, and/or 20, or another chromosome, e.g., including another region associated with SZ, pharmacological response, and/or psychiatric endophenotypes, and detecting binding of a nucleic acid from the sample to the array. Optionally, the method includes amplifying nucleic acid from the sample, e.g., genomic DNA that includes a portion of a human chromosome described herein, and, optionally, a region that includes another region associated with SZ, pharmacological response, and/or psychiatric endophenotypes, prior to or during contact with the array.

In some aspects, the methods described herein can include using an array that can ascertain differential expression patterns or copy numbers of one or more genes in samples from normal and affected individuals (see, e.g., Redon et al., Nature. 444(7118):444-54 (2006)). For example, arrays of probes to a marker described herein can be used to measure polymorphisms between DNA from a subject having SZ and control DNA, e.g., DNA obtained from an individual that does not have SZ and has no familial risk factors for SZ. Since the clones on the array contain sequence tags, their positions on the array are accurately known relative to the genomic sequence. Different hybridization patterns between DNA from an individual afflicted with SZ and DNA from a normal individual at areas in the array corresponding to markers in human chromosome 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, and/or 20 as described herein, and, optionally, one or more other regions associated with SZ, SD, or SPD, are indicative of a risk of SZ-spectrum disorders. Methods for array production, hybridization, and analysis are described, e.g., in Snijders et al., (2001) Nat. Genetics 29:263-264; Klein et al., (1999) Proc. Natl Acad. Sci. U.S.A. 96:4494-4499; Albertson et al., (2003) Breast Cancer Research and Treatment 78:289-298; and Snijders et al. “BAC microarray based comparative genomic hybridization.” In: Zhao et al. (eds), Bacterial Artificial Chromosomes: Methods and Protocols, Methods in Molecular Biology, Humana Press, 2002. Real time quantitative PCR can also be used to determine copy number.

In another aspect, the invention features methods of determining the absence or presence of a haplotype associated with SZ, pharmacological response, and/or psychiatric endophenotypes, as described herein, using an array described above. For example, in some embodiments the methods include providing a two dimensional array having a plurality of addresses, each address of the plurality being positionally distinguishable from each other address of the plurality having a unique nucleic acid capture probe, contacting the array with a first sample from a test subject who is suspected of having or being at risk for SZ, and comparing the binding of the first sample with one or more references, e.g., binding of a sample from a subject who is known to have SZ and/or binding of a sample from a subject who is unaffected, e.g., a control sample from a subject that does not have SZ. In some embodiments, the methods include contacting the array with a second sample from a subject who has SZ; and comparing the binding of the first sample with the binding of the second sample. In some embodiments, the methods include contacting the array with a third sample from a subject that does not have SZ; and comparing the binding of the first sample with the binding of the third sample. In some embodiments, the second and third samples are from first or second-degree relatives of the test subject. Binding, e.g., in the case of a nucleic acid hybridization, with a capture probe at an address of the plurality, can be detected by any method known in the art, e.g., by detection of a signal generated from a label attached to the nucleic acid.

Schizophrenia, Schizotypal Personality Disorder, and Schizoaffective Disorder

The methods described herein can be used to determine an individual's risk of developing schizophrenia (SZ), which as defined herein includes narrowly defined SZ as well as schizotypal personality disorder (SPD), and/or schizoaffective disorder (SD).

Schizophrenia (SZ)

SZ is considered a clinical syndrome, and is probably a constellation of several pathologies. Substantial heterogeneity is seen between cases; this is thought to reflect multiple overlapping etiologic factors, including both genetic and environmental contributions. A diagnosis of SZ is typically indicated by chronic psychotic symptoms, e.g., hallucinations and delusions. Disorganization of thought and behavior are common and are considered distinguishing factors in the diagnosis of SZ. Patients typically have some subtle impairments in cognition. Reduced emotional experience and expression, low drive, and impaired speech are observed in a subgroup of patients. Cognitive, emotional and social impairments often appear early in life, while the psychotic symptoms typically manifest in late adolescence or early adulthood in men, a little later in women.

A diagnosis of SZ can be made according to the criteria reported in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, American Psychiatric Association, 2000, (referred to herein as DSM-IV) as follows:

Diagnostic Criteria for SZ

All six criteria must be met for a diagnosis of SZ.

A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a one month period (or less if successfully treated):

(1) delusions

(2) hallucinations

(3) disorganized speech (e.g., frequent derailment or incoherence)

(4) grossly disorganized or catatonic behavior

(5) negative symptoms, e.g., affective flattening, alogia, or avolition

Only one criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

D. Schizoaffective and Mood Disorder Exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

E. Substance/General Medical Condition Exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

F. Relationship to a Pervasive Developmental Disorder: If the patient has a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of SZ is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

Schizoaffective Disorder (SD)

SD is characterized by the presence of affective (depressive or manic) symptoms and schizophrenic symptoms within the same, uninterrupted episode of illness.

Diagnostic Criteria for Schizoaffective Disorder

The DSM-IV Criteria for a diagnosis of schizoaffective disorder is as follows: An uninterrupted period of illness during which, at some time, there is either (1) a Major Depressive Episode (which must include depressed mood), (2) a Manic Episode, or (3) a Mixed Episode, concurrent with symptoms that meet (4) Criterion A for SZ, above.

A. Criteria for Major Depressive Episode

At least five of the following symptoms must be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). In children and adolescents, this can be an irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (In children, failure to make expected weight gains is considered).

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

In addition, the symptoms do not meet criteria for a Mixed Episode. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months, or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

B. Criteria for Manic Episode

A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week (or any duration, if hospitalization is necessary).

During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

(1) inflated self-esteem or grandiosity

(2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

(3) more talkative than usual or pressure to keep talking

(4) flight of ideas or subjective experience that thoughts are racing

(5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

(6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

(7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

The symptoms do not meet criteria for a Mixed Episode. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

C. Criteria for Mixed Episode

A mixed episode occurs when the criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

D. Criterion A of SZ

See above.

E. Types of SD

The type of SD may be may be specifiable, as either Bipolar Type, if the disturbance includes a Manic or a Mixed Episode (or a Manic or a Mixed Episode and Major Depressive Episodes), or Depressive Type, if the disturbance only includes Major Depressive Episodes.

F. Associated Features Features associated with SD include Learning Problems, Hypoactivity, Psychotic, Euphoric Mood, Depressed Mood, Somatic/Sexual Dysfunction, Hyperactivity, Guilt/Obsession, Odd/Eccentric/Suspicious Personality, Anxious/Fearful/Dependent Personality, and Dramatic/Erratic/Antisocial Personality.

Schizotypal Personality Disorder (SPD)

Diagnostic Criteria for SPD

A diagnosis of SPD under the criteria of the DSM-IV is generally based on a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) ideas of reference (excluding delusions of reference)

(2) odd beliefs or magical thinking that influences behavior and is

(3) inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense;” in children and adolescents, bizarre fantasies or preoccupations)

(4) unusual perceptual experiences, including bodily illusions

(5) odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)

(6) suspiciousness or paranoid ideation

(7) inappropriate or constricted affect

(8) behavior or appearance that is odd, eccentric, or peculiar

(9) lack of close friends or confidants other than first-degree relatives

(10) excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self

SPD is diagnosed if the symptoms do not occur exclusively during the course of SZ, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder, and the disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Associated features of SPD include Depressed Mood and Odd/Eccentric/Suspicious Personality.

Psychiatric Endophenotypes in SZ

A number of endophenotypes, i.e., intermediate phenotypes, that may more closely reflect biological mechanisms behind SZ, have been suggested, such as prepulse inhibition, structural abnormalities evident in MRI scans, specific domains of cognition (e.g., executive function), fine motor performance, working memory, etc.

Endophenotypes can also include clinical manifestations such as hallucinations, paranoia, mania, depression, obsessive-compulsive symptoms, etc., as well as response or lack of response to drugs and comorbidity for substance and alcohol abuse. See, e.g., Kendler et al., Am J Psychiatry 152(5):749-54 (1995); Gottesman and Gould, Am J Psychiatry 160(4):636-45 (2003); Cadenhead, Psychiatric Clinics of North America. 25(4):837-53 (2002); Gottesman and Gould, American Journal of Psychiatry. 160(4):636-45 (2003); Heinrichs, Neuroscience & Biobehavioral Reviews. 28(4):379-94 (2004); and Zobel and Maier, Nervenarzt. 75(3):205-14 (2004). There is now evidence that some candidate genes that were identified using DSM-IV type categorical definitions for “affected” individuals may influence specific endophenotypes, see, e.g., Baker et al., Biol Psychiatry 58(1):23-31 (2005); Cannon et al., Arch Gen Psychiatry 62(11):1205-13 (2005); Gothelf et al., Nat Neurosci 8(11):1500-2 (2005); Hallmayer et al., Am J Hum Genet 77(3):468-76 (2005); Callicott et al., Proc Natl Acad Sci USA 102(24):8627-32 (2005); Gornick et al., J Autism Dev Disord 1-8 (2005). Thus, the methods described herein can be used to associate haplotypes with specific psychiatric endophenotypes.

Positive and Negative Syndrome Scale (PANSS)

The Positive and Negative Syndrome Scale (PANSS) is a comprehensive psychometric scale used to classify psychopathology for severe neuropsychiatric diseases, including SZ. It measures a number of psychiatric endophenotypes or dimensions using quantitative scales based on the scoring of patients by clinicians. It is widely used to classify patients into specific subtypes, and is commonly used for measuring the improvement of symptoms in response to clinical interventions (Kay et al., Schizophr. Bull. 13:261-276 (1987); Kay et al., Br. J. Psychiatry Suppl 59-67 (1989); Leucht et al., Schizophr. Res. 79:231-238 (2005)).

Detailed information on PANSS and Scoring Criteria can be found in the art, e.g., on the world wide web at panss.org, or in the book by Kay, Positive and Negative Syndromes in Schizophrenia, (Routledge, 1991) which is incorporated herein in its entirety by reference. Based on these sources, the methodology is summarized briefly below.

PANSS comprises 30 individual subscales. Seven constitute a Positive Symptom Scale, seven the Negative Symptom Scale, and the remaining 16 items make up a General Psychopathology Scale. The scores for these scales are arrived at by summation of ratings across component items. Therefore, the potential ranges are 7 to 49 for the Positive and Negative Scales, and 16 to 112 for the General Psychopathology Scale (Source: The PANSS Institute).

Each of the 30 items is accompanied by a specific definition as well as detailed anchoring criteria for all seven rating points. These seven points represent increasing levels of psychopathology, as follows:

1—absent

2—minimal

3—mild

4—moderate

5—moderate severe

6—severe

7—extreme

The PANSS Individual subscales are described below.

P1. DELUSIONS—Beliefs which are unfounded, unrealistic and idiosyncratic.

P2. CONCEPTUAL DISORGANISATION—Disorganized process of thinking characterized by disruption of goal-directed sequencing, e.g., circumstantiality, loose associations, tangentiality, gross illogicality or thought block.

P3. HALLUCINATORY BEHAVIOUR—Verbal report or behaviour indicating perceptions which are not generated by external stimuli. These may occur in the auditory, visual, olfactory or somatic realms.

P4. EXCITEMENT—Hyperactivity as reflected in accelerated motor behaviour, heightened responsivity to stimuli, hypervigilance or excessive mood lability.

P5. GRANDIOSITY—Exaggerated self-opinion and unrealistic convictions of superiority, including delusions of extraordinary abilities, wealth, knowledge, fame, power and moral righteousness.

P6. SUSPICIOUSNESS/PERSECUTION—Unrealistic or exaggerated ideas of persecution, as reflected in guardedness, ad distrustful attitude, suspicious hypervigilance or frank delusions that others mean harm.

P7. HOSTILITY—Verbal and nonverbal expressions of anger and resentment, including sarcasm, passive-aggressive behavior, verbal abuse and assualtiveness.

N1. BLUNTED AFFECT—Diminished emotional responsiveness as characterized by a reduction in facial expression, modulation of feelings and communicative gestures.

N2. EMOTIONAL WITHDRAWAL—Lack of interest in, involvement with, and affective commitment to life's events.

N3. POOR RAPPORT—Lack of interpersonal empathy, openness in conversation and sense of closeness, interest or involvement with the interviewer. This is evidenced by interpersonal distancing and reduced verbal and nonverbal communication.

N4. PASSIVE/APATHETIC SOCIAL WITHDRAWAL—Diminished interest and initiative in social interactions due to passivity, apathy, anergy or avolition. This leads to reduced interpersonal involvements and neglect of activities of daily living.

N5. DIFFICULTY IN ABSTRACT THINKING—Impairment in the use of the abstract-symbolic mode of thinking, as evidenced by difficulty in classification, forming generalizations and proceeding beyond concrete or egocentric thinking in problem-solving tasks.

N6. LACK OF SPONTANEITY AND FLOW OF CONVERSATION—Reduction in the normal flow of communication associated with apathy, avolition, defensiveness or cognitive deficit. This is manifested by diminished fluidity and productivity of the verbal interactional process.

N7. STEREOTYPED THINKING—Decreased fluidity, spontaneity and flexibility of thinking, as evidenced in rigid, repetitious or barren thought content.

G1. SOMATIC CONCERN—Physical complaints or beliefs about bodily illness or malfunctions. This may range from a vague sense of ill being to clear-cut delusions of catastrophic physical disease.

G2. ANXIETY—Subjective experience of nervousness, worry, apprehension or restlessness, ranging from excessive concern about the present or future to feelings of panic.

G3. GUILT FEELINGS—Sense of remorse or self-blame for real or imagined misdeeds in the past.

G4. TENSION—Overt physical manifestations of fear, anxiety, and agitation, such as stiffness, tremor, profuse sweating and restlessness.

G5. MANNERISMS AND POSTURING—Unnatural movements or posture as characterized be an awkward, stilted, disorganized, or bizarre appearance.

G6. DEPRESSION—Feelings of sadness, discouragement, helplessness and pessimism.

G7. MOTOR RETARDATION—Reduction in motor activity as reflected in slowing or lessening or movements and speech, diminished responsiveness of stimuli, and reduced body tone.

G8. UNCOOPERATIVENESS—Active refusal to comply with the will of significant others, including the interviewer, hospital staff or family, which may be associated with distrust, defensiveness, stubbornness, negativism, rejection of authority, hostility or belligerence.

G9. UNUSUAL THOUGHT CONTENT—Thinking characterized by strange, fantastic or bizarre ideas, ranging from those which are remote or atypical to those which are distorted, illogical and patently absurd.

G10. DISORIENTATION—Lack of awareness of one's relationship to the milieu, including persons, place and time, which may be due to confusion or withdrawal.

G11. POOR ATTENTION—Failure in focused alertness manifested by poor concentration, distractibility from internal and external stimuli, and difficulty in harnessing, sustaining or shifting focus to new stimuli.

G12. LACK OF JUDGEMENT AND INSIGHT—Impaired awareness or understanding of one's own psychiatric condition and life situation. This is evidenced by failure to recognize past or present psychiatric illness or symptoms, denial of need for psychiatric hospitalization or treatment, decisions characterized by poor anticipation or consequences, and unrealistic short-term and long-range planning.

G13. DISTURBANCE OF VOLITION—Disturbance in the willful initiation, sustenance and control of one's thoughts, behavior, movements and speech.

G14. POOR IMPULSE CONTROL—Disordered regulation and control of action on inner urges, resulting in sudden, unmodulated, arbitrary or misdirected discharge of tension and emotions without concern about consequences.

G15. PREOCCUPATION—Absorption with internally generated thoughts and feelings and with autistic experiences to the detriment of reality orientation and adaptive behavior.

G16. ACTIVE SOCIAL AVOIDANCE—Diminished social involvement associated with unwarranted fear, hostility, or distrust.

Use of PANSS Score for Differential Diagnosis

Each patient's disease manifestation and process is unique. PANSS provides a structured, objective way of describing the various aspects of psychopathology of a given patient. However, proper implementation of the PANSS requires highly trained personnel to conduct the assessment and to interpret the results, and there is potential for site to site variability, especially outside the research setting.

Each of the PANSS composite scales and subscales can be considered a clinical endophenotype. The ability to link genetic profiles to these clinical endophenotypes, as described in the examples, will enable clinicians to refine a patient's diagnosis and develop a personalized therapeutic strategy for each patient. For example, the “A” allele of rs4832524, located in the KCNS3 gene, is associated with lower Negative Symptom burden as shown in the regression analysis in Table 14. Another example is the “A” allele of rs9823803, located in the GADL1 gene, which is significantly associated with lower scores on the Grandiosity Subscale as shown in the regression analysis in Table 15. By identifying these genetic contributions to specific endophenotypes, the physician can create a personalized diagnosis and treatment regime for the patient.

Current Treatment of SZ

Subjects with SZ typically require acute treatment for psychotic exacerbations, and long-term treatment including maintenance and prophylactic strategies to sustain symptom improvement and prevent recurrence of psychosis. Subjects with schizoaffective disorder experience the symptoms of both SZ and affective disorder (manic and/or depressive), thus require the specific treatments for each disorder. Subjects with SPD sometimes require medication for acute psychotic episodes but are often treated using psychosocial methods. The methods described herein can include the administration of one or more accepted or experimental treatment modalities to a person identified as at risk of developing SZ, SPD, or a SD, based on the presence of a haplotype associated with SZ, SPD, or SD. Currently accepted treatments presently include both pharmacologic and psychosocial management, and occasionally electroconvulsive therapy (ECT).

Standard pharmacologic therapies for SZ and SD include the administration of one or more antipsychotic medications, which are typically antagonists acting at postsynaptic D2 dopamine receptors in the brain. Antipsychotic medications include conventional, or first generation, antipsychotic agents, which are sometimes referred to as neuroleptics because of their neurologic side effects, and second generation antipsychotic agents, which are less likely to exhibit neuroleptic effects and have been termed atypical antipsychotics.

In some embodiments, the methods described herein include the administration of one or more antipsychotic medications to a person identified by a method described herein as being at risk of developing SZ. Antipsychotic medications substantially reduce the risk of relapse in the stable phase of illness. In some embodiments, the methods include the administration of a first generation antipsychotic medication at a dose that is around the “extrapyramidal symptom (EPS) threshold” (i.e., the dose that will induce extrapyramidal side effects, e.g., bradykinesia, rigidity, or dyskinesia, with minimal rigidity detectable on physical examination, and/or a second-generation antipsychotics at a dose that is therapeutic, yet below the EPS threshold.

Standard pharmacologic therapies for SD also include the administration of a combination of antidepressant, and anti-anxiety medication. Suitable antidepressants include serotonergic antidepressants, e.g., fluoxetine or trazodone. Suitable anxiolytics include benzodiazepines, e.g., lorazepam, clonazepam. Lithium can also be administered. Thus, in some embodiments, the methods can include the administration of one or more antidepressant and/or anti-anxiety medications to a person identified as at risk of developing SZ.

The methods can also include psychosocial and rehabilitation interventions, e.g., interventions that are generally accepted as therapeutically beneficial, e.g., cognitive-behavioral therapy for treatment-resistant positive psychotic symptoms; supportive, problem-solving, educationally oriented psychotherapy; family therapy and education programs aimed at helping patients and their families understand the patient's illness, reduce stress, and enhance coping capabilities; social and living skills training; supported employment programs; and/or the provision of supervised residential living arrangements.

Currently accepted treatments for SZ are described in greater detail in the Practice Guideline for the Treatment of Patients With Schizophrenia, American Psychiatric Association, Second Edition, American Psychiatric Association, 2004, which is incorporated herein by reference in its entirety.

Methods of Determining Treatment Regimens and Methods of Treating SZ

As described herein, the presence of certain haplotypes described herein has been correlated with an increased risk of developing or having SZ; in addition, haplotypes are described herein that are correlated with altered response to a treatment, e.g., a pharmacological treatment. An altered response can be, for example, a positive response (i.e., an improvement in one or more symptoms of the disease), negative response (worsening of one or more symptoms of the disease), no response, or the presence or absence of side effects. Thus, the new methods can also include selecting a treatment regimen for a subject determined to have SZ or to be at risk for developing SZ, based upon the absence or presence of a haplotype described herein. The determination of a treatment regimen can also be based upon the absence or presence of other risk factors associated with SZ, e.g., as described herein. Therefore, the methods of the invention can include selecting a treatment regimen for a subject having one or more risk factors for SZ, and having a haplotype described herein. The methods can also include administering a selected treatment regimen to a subject having, or at risk for developing, SZ, to thereby treat, prevent or delay further progression of the disease. A treatment regimen can include the administration of a selected antipsychotic medications to a subject identified as at risk of developing SZ, before the onset of any psychotic episodes. The medications can be selected based on the presence of a haplotype that is associated with, for example, positive response, or the absence of significant side effects.

As used herein, the term “treat” or “treatment” is defined as the application or administration of a treatment regimen, e.g., a therapeutic agent or modality, to a subject, e.g., a patient. The subject can be a patient having SZ a symptom of SZ or at risk of developing (i.e., a predisposition toward) SZ. The treatment can be to cure, heal, alleviate, relieve, alter, remedy, ameliorate, palliate, improve or affect SZ, the symptoms of SZ or the predisposition toward SZ.

The methods described herein, e.g., methods of determining a treatment regimen and methods of treatment or prevention of SZ can further include the step of monitoring the subject, e.g., for a change (e.g., an increase or decrease) in one or more of the diagnostic criteria for SZ listed herein, or any other parameter related to clinical outcome. The subject can be monitored in one or more of the following periods: prior to beginning of treatment; during the treatment; or after one or more elements of the treatment have been administered. Monitoring can be used to evaluate the need for further treatment with the same or a different therapeutic agent or modality. Generally, a decrease in one or more of the parameters described above is indicative of the improved condition of the subject, although with red blood cell and platelet levels, an increase can be associated with the improved condition of the subject.

The methods can be used, e.g., to evaluate the suitability of, or to choose between alternative treatments, e.g., a particular dosage, mode of delivery, time of delivery, inclusion of adjunctive therapy, e.g., administration in combination with a second agent, or generally to determine the subject's probable drug response genotype. In a preferred embodiment, a treatment for SZ can be evaluated by administering the same treatment or combinations or treatments to a subject having SZ and a haplotype as described herein and to a subject that has SZ but does not have a haplotype as described herein. The effects of the treatment or combination of treatments on each of these subjects can be used to determine if a treatment or combination of treatments is particularly effective on a sub-group of subjects having SZ. In other embodiments, various treatments or combinations of treatments can be evaluated by administering two different treatments or combinations of treatments to at least two different subjects having SZ, and a haplotype as described herein. Such methods can be used to determine if a particular treatment or combination of treatments is more effective than others in treating this subset of SZ patients.

Various treatment regimens are known for treating SZ, e.g., as described herein.

Pharmacogenomics

With regards to both prophylactic and therapeutic methods of treatment of SZ, such treatments may be specifically tailored or modified, based on knowledge obtained from the field of pharmacogenomics. “Pharmacogenomics,” as used herein, refers to the application of genomics technologies such as structural chromosomal analysis, to drugs in clinical development and on the market. See, for example, Eichelbaum et al., Clin. Exp. Pharmacol. Physiol. 23:983-985 (1996) and Linder et al., Clin. Chem. 43:254-266 (1997). Specifically, as used herein, the term refers the study of how a patient's genes determine his or her response to a drug (e.g., a patient's “drug response phenotype,” or “drug response genotype”). Thus, another aspect of the invention provides methods for tailoring an individual's prophylactic or therapeutic treatment according to that individual's drug response genotype.

Information generated from pharmacogenomic research using a method described herein can be used to determine appropriate dosage and treatment regimens for prophylactic or therapeutic treatment of an individual. This knowledge, when applied to dosing or drug selection, can avoid adverse reactions or therapeutic failure and thus enhance therapeutic or prophylactic efficiency when administering a therapeutic composition, e.g., a cytotoxic agent or combination of cytotoxic agents, to a patient, as a means of treating or preventing SZ.

In one embodiment, a physician or clinician may consider applying knowledge obtained in relevant pharmacogenomics studies, e.g., using a method described herein, when determining whether to administer a pharmaceutical composition, e.g., an antipsychotic agent or a combination of antipsychotic agents, to a subject. In another embodiment, a physician or clinician may consider applying such knowledge when determining the dosage, e.g., amount per treatment or frequency of treatments, of a treatment, e.g., a antipsychotic agent or combination of antipsychotic agents, administered to a patient.

As one example, a physician or clinician may determine (or have determined, e.g., by a laboratory) the haplotype of a subject as described herein, and optionally one or more other markers associated with SZ of one or a group of subjects who may be participating in a clinical trial, wherein the subjects have SZ, and the clinical trial is designed to test the efficacy of a pharmaceutical composition, e.g., an antipsychotic or combination of antipsychotic agents, and wherein the physician or clinician attempts to correlate the genotypes of the subjects with their response to the pharmaceutical composition.

As another example, information regarding a haplotype associated with an altered pharmacogenomic response for SZ as described herein, can be used to stratify or select a subject population for a clinical trial. The information can, in some embodiments, be used to stratify individuals that may exhibit a toxic response to a treatment from those that will not. In other cases, the information can be used to separate those that are more likely to be non-responders from those who will be responders. The haplotypes described herein can be used in pharmacogenomics-based design and to manage the conduct of a clinical trial, e.g., as described in U.S. Pat. Pub. No. 2003/0108938.

As another example, information regarding a haplotype associated with an increased risk of SZ, or with altered pharmacogenomic response for SZ, as described herein, can be used to stratify or select human cells or cell lines for drug testing purposes. Human cells are useful for studying the effect of a polymorphism on physiological function, and for identifying and/or evaluating potential therapeutic agents for the treatment of SZ e.g., anti-psychotics. Thus the methods can include performing the present methods on genetic material from a cell line. The information can, in some embodiments, be used to separate cells that respond particular drugs from those that do not respond, e.g. which cells show altered second messenger signaling.

Theranostics

Also included herein are compositions and methods for the identification and treatment of subjects who have an increased risk of SZ, or altered clinical presentation of SZ, such that a theranostic approach can be taken to test such individuals to determine the effectiveness of a particular therapeutic intervention (e.g., a pharmaceutical or non-pharmaceutical intervention as described herein) and to alter the intervention to 1) reduce the risk of developing adverse outcomes and 2) enhance the effectiveness of the intervention. Thus, in addition to diagnosing or confirming the predisposition to SZ, the methods and compositions described herein also provide a means of optimizing the treatment of a subject having SZ. Provided herein is a theranostic approach to treating and preventing SZ, by integrating diagnostics and therapeutics to improve the real-time treatment of a subject. Practically, this means creating tests that can identify which patients are most suited to a particular therapy, and providing feedback on how well a drug is working to optimize treatment regimens.

Within the clinical trial setting, a theranostic method or composition of the invention can provide key information to optimize trial design, monitor efficacy, and enhance drug safety. For instance, “trial design” theranostics can be used for patient stratification, determination of patient eligibility (inclusion/exclusion), creation of homogeneous treatment groups, and selection of patient samples that are representative of the general population. Such theranostic tests can therefore provide the means for patient efficacy enrichment, thereby minimizing the number of individuals needed for trial recruitment. “Efficacy” theranostics are useful for monitoring therapy and assessing efficacy criteria. Finally, “safety” theranostics can be used to prevent adverse drug reactions or avoid medication error.

The methods described herein can include retrospective analysis of clinical trial data as well, both at the subject level and for the entire trial, to detect correlations between a haplotype as described herein and any measurable or quantifiable parameter relating to the outcome of the treatment, e.g., efficacy (the results of which may be binary (i.e., yes and no) as well as along a continuum), side-effect profile (e.g., weight gain, metabolic dysfunction, lipid dysfunction, movement disorders, or extrapyramidal symptoms), treatment maintenance and discontinuation rates, return to work status, hospitalizations, suicidality, total healthcare cost, social functioning scales, response to non-pharmacological treatments, and/or dose response curves. The results of these correlations can then be used to influence decision-making, e.g., regarding treatment or therapeutic strategies, provision of services, and/or payment. For example, a correlation between a positive outcome parameter (e.g., high efficacy, low side effect profile, high treatment maintenance/low discontinuation rates, good return to work status, low hospitalizations, low suicidality, low total healthcare cost, high social function scale, favorable response to non-pharmacological treatments, and/or acceptable dose response curves) and a selected haplotype can influence treatment such that the treatment is recommended or selected for a subject having the selected haplotype.

Kits

Also within the scope of the invention are kits comprising a probe that hybridizes with a region of human chromosome as described herein and can be used to detect a polymorphism described herein. The kit can include one or more other elements including: instructions for use; and other reagents, e.g., a label, or an agent useful for attaching a label to the probe. Instructions for use can include instructions for diagnostic applications of the probe for assessing risk of SZ in a method described herein. Other instructions can include instructions for attaching a label to the probe, instructions for performing in situ analysis with the probe, and/or instructions for obtaining a sample to be analyzed from a subject. As discussed above, the kit can include a label, e.g., any of the labels described herein. In some embodiments, the kit includes a labeled probe that hybridizes to a region of human chromosome as described herein, e.g., a labeled probe as described herein.

The kit can also include one or more additional probes that hybridize to the same chromosome, e.g., chromosome 1, 3, 6, 10, 11, 12, 13, 14, 15, 15, 17, 18, 19, or 20, or another chromosome or portion thereof that can have an abnormality associated with risk for SZ. For example, the additional probe or probes can be: a probe that hybridizes to human chromosome 22q11-12 or a portion thereof, (e.g., a probe that detects a sequence associated with SZ or BD in this region of chromosome 22), or probes that hybridize to all or a portion of 22q12.3 (e.g., near D22S283), 22q11.2, 22q11.2, 22q11-q13, 1q42.1, 1q42.1, 1q21-q22, 2p, 2q, 3p25, 4p, 4q, 5q11.2-q13.3, 6p22.3, 6p23, 6q13-q26, 7q, 8p12-21, 8q, 9p, 10p15-p13 (e.g., near D105189), 10q22.3, 11q14-q21, 12q24, 13q34, 13q32, 14q32.3, 15q15, 16p, 17q, 18p, 18q, 19p. 20p, 21q, Xq, and/or the X/Y pseudoautosomal region. A kit that includes additional probes can further include labels, e.g., one or more of the same or different labels for the probes. In other embodiments, the additional probe or probes provided with the kit can be a labeled probe or probes. When the kit further includes one or more additional probe or probes, the kit can further provide instructions for the use of the additional probe or probes.

Kits for use in self-testing can also be provided. For example, such test kits can include devices and instructions that a subject can use to obtain a sample, e.g., of buccal cells or blood, without the aid of a health care provider. For example, buccal cells can be obtained using a buccal swab or brush, or using mouthwash.

Kits as provided herein can also include a mailer, e.g., a postage paid envelope or mailing pack, that can be used to return the sample for analysis, e.g., to a laboratory. The kit can include one or more containers for the sample, or the sample can be in a standard blood collection vial. The kit can also include one or more of an informed consent form, a test requisition form, and instructions on how to use the kit in a method described herein. Methods for using such kits are also included herein. One or more of the forms, e.g., the test requisition form, and the container holding the sample, can be coded, e.g., with a bar code, for identifying the subject who provided the sample.

Databases

Also provided herein are databases that include a list of polymorphisms as described herein, and wherein the list is largely or entirely limited to polymorphisms identified as useful in performing genetic diagnosis of or determination of susceptibility to SZ as described herein. The list is stored, e.g., on a flat file or computer-readable medium. The databases can further include information regarding one or more subjects, e.g., whether a subject is affected or unaffected, clinical information such as endophenotype, age of onset of symptoms, any treatments administered and outcomes (e.g., data relevant to pharmacogenomics, diagnostics or theranostics), and other details, e.g., about the disorder in the subject, or environmental or other genetic factors. The databases can be used to detect correlations between a particular haplotype and the information regarding the subject, e.g., to detect correlations between a haplotype and a particular endophenotype, or treatment response.

Engineered Cells

Also provided herein are engineered cells that harbor one or more polymorphism described herein, e.g., one or more polymorphisms that constitute a haplotype associated with SZ, altered drug response or a specific endophenotype. Such cells are useful for studying the effect of a polymorphism on physiological function, and for identifying and/or evaluating potential therapeutic agents for the treatment of SZ-spectrum disorders e.g., anti-psychotics.

As one example, included herein are cells in which one of the various alleles of the genes described herein has be re-created that is associated with an increased risk of SZ. Methods are known in the art for generating cells, e.g., by homologous recombination between the endogenous gene and an exogenous DNA molecule introduced into a cell, e.g., a cell of an animal. In some embodiments, the cells can be used to generate transgenic animals using methods known in the art.

The cells are preferably mammalian cells, e.g., neuronal type cells, in which an endogenous gene has been altered to include a polymorphism as described herein. Techniques such as targeted homologous recombinations, can be used to insert the heterologous DNA as described in, e.g., Chappel, U.S. Pat. No. 5,272,071; WO 91/06667, published in May 16, 1991.

EXAMPLES

The invention is further described in the following examples, which do not limit the scope of the invention described in the claims.

Example 1 Novel Markers Associated with SZ

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), a large federally funded clinical trial designed to assess the efficacy of antipsychotics in a real world setting, is a valuable resource for determining the role of genes in drug response (Stroup et al., Schizophr. Bull. 29:15-31 (2003); Lieberman et al., N. Engl. J. Med. 353:1209-1223 (2005)). As part of the CATIE trial, SNP genotyping was performed for roughly half of the trial participants (Sullivan et al., Mol. Psychiatry 13:570-584 (2008)). When combined with disease status, PANSS scores, and clinical drug response data, the genotyping data allows the identification of genetic variants (e.g., SNPs) that are statistically associated with increased risk of developing SZ.

The design of the CATIE study has been described in detail by others (see, e.g., Stroup et al., Schizophr. Bull. 29:15-31 (2003); Lieberman et al., N. Engl. J. Med. 353:1209-1223 (2005)). Briefly, 1460 subjects were randomly assigned one of several antipsychotics and those who did not respond or chose to quit their current medication were re-randomized to another drug. Details regarding SNP genotyping and quality control have been recently published (Sullivan et al., Mol. Psychiatry 13:570-584 (2008)).

Genotype and phenotype data for the CATIE trial were made available to qualified researchers through the NIMH Center for Collaborative Genetic Studies on Mental Disorders. Data for 417 patients with schizophrenia and 419 unaffected controls self reported as having exclusively European ancestry were evaluated. This same patient population was described in a recent study by Sullivan and coworkers, which confirmed that there is no hidden stratification in the sample (Sullivan et al., Mol. Psychiatry 13:570-584 (2008)).

In addition, for this example, genotyping and phenotype data were obtained from the Genetic Analysis Information Network (GAIN) Database found at ncbi.nlm.nih.gov through dbGaP, at accession number PHS000017.v1.p1. Genotypes and associated phenotype data for the GAIN Genome-Wide Association Study of Schizophrenia were provided by P. Gejman, and genotyping of these samples was provided through the Genetic Association Information Network (GAIN). Data for 1172 cases and 1378 controls with Caucasian ancestry were evaluated for the GAIN sample.

For both the CATIE and GAIN studies, individual cases were diagnosed as having SZ based on DSM-III/IV criteria.

Statistical Methods:

Genetic analysis to document the influence of haplotypes on SZ risk was performed using the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of Novel Markers Associated with SZ Risk:

Table 1 provides numerous examples of SNP-based alleles that influence SZ risk. Table 1 reports the minor allele frequencies, P values, and ORs for numerous SNPs, in Tables B and C, that affect SZ risk. ORs of >1.0 indicate that the minor SNP allele is associated with greater susceptibility, and ORs of <1.0 indicate that the minor SNP allele is associated with decreased susceptibility to SZ.

Note in Table 1 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Table 1, unless the test SNP was evaluated in both the CATIE and GAIN samples.

TABLE 1 Confirmation of Novel Markers Associated with SZ risk Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele Cases P OR Study CAMTA1 rs10864639 rs1542899 1.00 C 0.086 0.008304 0.78 GAIN CAMTA1 rs845197 rs2097518 0.71 C 0.249 0.02548 0.87 GAIN CAMTA1 rs2071986 rs9919223 1.00 T 0.267 0.0347 0.88 GAIN RERE rs12136689 rs10779702 0.76 A 0.355 0.006746 1.18 GAIN RERE rs8627 rs10779702 0.52 A 0.355 0.006746 1.18 GAIN RP1-21O18.1 rs7546786 rs7546786 N/A C 0.211 0.0356 0.78 CATIE RP1-21O18.1 rs2073091 rs761288 0.69 C 0.269 0.04654 1.14 GAIN RP1-21O18.1 rs4661572 rs761288 0.56 C 0.269 0.04654 1.14 GAIN RP1-21O18.1 rs12057431 rs10803343 1.00 C 0.016 0.03243 3.20 CATIE KCND3 rs4838924 rs1373291 0.86 T 0.224 0.04121 1.28 CATIE VAMP4 rs10913530 rs9943293 1.00 T 0.311 0.01885 1.29 CATIE VAMP4 rs12096984 rs9943293 1.00 T 0.311 0.01885 1.29 CATIE VAMP4 rs2073484 rs9943293 1.00 T 0.311 0.01885 1.29 CATIE VAMP4 rs6672082 rs9943293 1.00 T 0.311 0.01885 1.29 CATIE VAMP4 rs15655 rs10913529 1.00 C 0.182 0.00696 0.83 GAIN DNM3 rs2093184 rs7540873 0.62 T 0.282 0.03038 0.88 GAIN DNM3 rs7554526 rs7540873 0.61 T 0.282 0.03038 0.88 GAIN DNM3 rs9425287 rs10158839 1.00 C 0.513 0.04037 1.12 GAIN FASLG rs10458360 rs10458360 N/A G 0.474 0.02088 1.14 GAIN FASLG rs12135884 rs10458360 0.56 G 0.474 0.02088 1.14 GAIN CACNA1E rs553042 rs553042 N/A G 0.304 0.006968 1.18 GAIN CACNA1E rs17494681 rs17494681 N/A A 0.188 0.01055 1.21 GAIN CACNA1E rs506947 rs7554158 1.00 A 0.109 0.01115 0.80 GAIN CACNA1E rs638132 rs546191 0.67 T 0.193 0.01582 0.75 CATIE CAMK1G rs6690557 rs9429821 0.69 C 0.317 0.04072 0.88 GAIN SYT14 rs9429830 rs7543650 0.52 T 0.236 0.02059 0.77 CATIE SYT14 rs9429830 rs227193 0.90 G 0.400 0.0183 0.87 GAIN KCNH1 rs1770220 rs1340127 0.51 G 0.437 0.01888 0.87 GAIN ANK3 rs1050745 rs1050745 N/A T 0.209 0.02123 0.86 GAIN ANK3 rs2393607 rs1078534 0.82 C 0.173 0.01647 0.74 CATIE ANK3 rs11596260 rs11596260 N/A T 0.351 0.03773 0.89 GAIN ANK3 rs2241540 rs11596260 1.00 T 0.351 0.03773 0.89 GAIN ANK3 rs1551684 rs1551683 1.00 T 0.114 0.0462 0.75 CATIE KCNQ1 rs2283174 rs2283179 0.52 C 0.132 0.04204 1.19 GAIN KCNQ1 rs231348 rs10832405 0.80 A 0.126 0.0203 1.45 CATIE RHOG rs11030008 rs1869002 0.67 G 0.312 0.007693 1.34 CATIE USH1C rs2237965 rs1076311 0.63 G 0.472 0.03922 1.23 CATIE USH1C rs10766408 rs2237959 0.53 G 0.454 0.01149 1.29 CATIE USH1C rs2041027 rs10766410 0.54 A 0.461 0.0002016 1.45 CATIE USH1C rs2237957 rs10766410 0.62 A 0.461 0.0002016 1.45 CATIE OTOG rs10766410 rs10766410 N/A A 0.461 0.0002016 1.45 CATIE OTOG rs2073582 rs10766410 0.55 A 0.461 0.0002016 1.45 CATIE SERGEF rs4757589 rs4757589 N/A G 0.497 0.001605 1.19 GAIN NAV2 rs10766590 rs10500860 0.59 G 0.308 0.02614 1.15 GAIN NAV2 rs2042600 rs1559665 0.93 T 0.480 0.02766 0.88 GAIN NAV2 rs2278132 rs1559665 0.87 T 0.480 0.02766 0.88 GAIN NAV2 rs7119267 rs7119267 N/A C 0.346 0.02078 1.15 GAIN NAV2 rs2028570 rs2255677 0.58 A 0.441 0.01665 1.15 GAIN NAV2 rs2289566 rs10732471 0.57 A 0.227 0.009299 0.84 GAIN SLC17A6 rs11026532 rs1155331 0.96 T 0.265 0.02007 0.86 GAIN LRRC4C rs1551833 rs4237678 0.54 C 0.188 0.002021 1.26 GAIN LRRC4C rs10837367 rs1377106 1.00 A 0.067 0.00126 0.57 CATIE HSD17B12 rs1061810 rs7116641 0.54 G 0.346 0.02577 1.27 CATIE HSD17B12 rs4755744 rs7116641 0.65 G 0.346 0.02577 1.27 CATIE HSD17B12 rs10838160 rs10838166 1.00 G 0.383 0.003094 0.75 CATIE HSD17B12 rs3802891 rs10838166 1.00 G 0.383 0.003094 0.75 CATIE PHACS rs16937817 rs7950395 0.58 A 0.141 0.00271 1.29 GAIN PHACS rs7950395 rs7950395 N/A A 0.141 0.00271 1.29 GAIN SYT13 rs12362429 rs7124508 0.64 A 0.425 0.02358 0.88 GAIN SYT13 rs11038382 rs1077491 1.00 T 0.290 0.0195 0.78 CATIE SYT13 rs2863182 rs1077491 0.84 T 0.290 0.0195 0.78 CATIE SYT13 rs4992029 rs1077491 0.61 T 0.290 0.0195 0.78 CATIE SYT13 rs12362429 rs7118408 0.70 G 0.419 0.01028 0.78 CATIE ZFP91-CNTF rs1938596 rs2509920 0.97 G 0.404 0.01056 0.86 GAIN ZFP91-CNTF rs4319530 rs2509920 0.90 G 0.404 0.01056 0.86 GAIN ZFP91-CNTF rs7945889 rs948562 0.95 G 0.160 0.04957 0.86 GAIN ZFP91-CNTF rs948562 rs948562 N/A G 0.160 0.04957 0.86 GAIN DTX4 rs1048444 rs3847 1.00 A 0.353 0.01537 0.87 GAIN DTX4 rs2211912 rs3847 0.77 A 0.353 0.01537 0.87 GAIN DTX4 rs3847 rs3847 N/A A 0.353 0.01537 0.87 GAIN DTX4 rs5029315 rs3847 0.77 A 0.353 0.01537 0.87 GAIN DTX4 rs544864 rs3847 0.55 A 0.353 0.01537 0.87 GAIN DTX4 rs621162 rs3847 0.55 A 0.353 0.01537 0.87 GAIN DTX4 rs656163 rs3847 0.64 A 0.353 0.01537 0.87 GAIN KIAA1853 rs1568923 rs7298478 0.69 G 0.275 0.006263 0.84 GAIN KIAA1853 rs7134748 rs4767783 0.72 A 0.404 0.03728 1.13 GAIN KIAA1853 rs7969288 rs4767783 0.57 A 0.404 0.03728 1.13 GAIN KIAA1853 rs7297606 rs4075945 1.00 T 0.093 0.01915 1.27 GAIN RIMBP2 rs4237817 rs1877986 0.62 T 0.415 0.0264 0.80 CATIE CHFR rs2306541 rs7297261 0.96 A 0.315 0.04659 1.13 GAIN TTC5 rs3737220 rs4981948 1.00 C 0.175 0.006939 0.82 GAIN TTC5 rs2318864 rs4981951 0.52 C 0.185 0.01689 0.84 GAIN TTC5 rs3742945 rs4981951 0.52 C 0.185 0.01689 0.84 GAIN DACT1 rs11541 rs863091 1.00 A 0.202 0.04207 1.16 GAIN DACT1 rs160472 rs863091 0.54 A 0.202 0.04207 1.16 GAIN DACT1 rs863091 rs863091 N/A A 0.202 0.04207 1.16 GAIN DAAM1 rs4127823 rs12590850 0.61 A 0.416 0.02325 1.26 CATIE GPR135 rs10138199 rs1273156 0.81 T 0.459 0.02265 1.25 CATIE GPR135 rs1253181 rs1273156 1.00 T 0.459 0.02265 1.25 CATIE GPR135 rs17255731 rs1273156 0.62 T 0.459 0.02265 1.25 CATIE GPR135 rs4898989 rs1273156 0.81 T 0.459 0.02265 1.25 CATIE GPR135 rs9323348 rs1273156 0.81 T 0.459 0.02265 1.25 CATIE EML1 rs2273704 rs12590861 0.61 G 0.311 0.00485 1.19 GAIN EML1 rs7143905 rs12590861 0.70 G 0.311 0.00485 1.19 GAIN EML1 rs746698 rs11850280 0.91 G 0.190 0.008545 1.21 GAIN EML1 rs11160553 rs12435250 0.67 G 0.254 0.02602 0.87 GAIN EML1 rs12433613 rs12435250 0.56 G 0.254 0.02602 0.87 GAIN EML1 rs6575751 rs12435250 0.67 G 0.254 0.02602 0.87 GAIN EVL rs3206354 rs3206354 N/A T 0.053 0.03254 1.33 GAIN HERC2 rs11074322 rs6497272 1.00 G 0.017 0.03882 2.82 CATIE HERC2 rs1635168 rs8041209 0.87 T 0.087 0.0183 1.57 CATIE HERC2 rs2238289 rs8041209 0.51 T 0.087 0.0183 1.57 CATIE HERC2 rs7495174 rs8041209 0.58 T 0.087 0.0183 1.57 CATIE HERC2 rs11631797 rs916977 0.86 T 0.195 0.03981 1.30 CATIE HERC2 rs916977 rs916977 N/A T 0.195 0.03981 1.30 CATIE UNC13C rs2115827 rs12148800 0.97 C 0.470 0.02906 0.88 GAIN UNC13C rs2163195 rs2115825 0.57 A 0.501 0.02333 1.14 GAIN UNC13C rs12594549 rs934192 0.85 T 0.175 0.001305 1.28 GAIN UNC13C rs1897069 rs1897069 N/A C 0.449 0.01113 0.87 GAIN UNC13C rs12910912 rs12900128 0.52 G 0.295 0.01764 1.16 GAIN UNC13C rs11856476 rs12917023 0.70 G 0.172 0.04217 1.17 GAIN NEDD4 rs4424863 rs4520787 0.90 A 0.397 0.03785 1.24 CATIE NEDD4 rs8028559 rs11630780 0.69 C 0.396 0.01945 0.79 CATIE NEDD4 rs17238461 rs2175104 0.53 A 0.108 0.03922 1.42 CATIE NEDD4 rs1509408 rs1509408 N/A C 0.225 0.03142 0.78 CATIE AKAP13 rs2291049 rs16941653 0.59 T 0.070 0.01822 0.66 CATIE AKAP13 rs338556 rs2241266 1.00 T 0.071 0.0406 0.81 GAIN KLHL25 rs2430838 rs2241266 0.91 T 0.071 0.0406 0.81 GAIN SV2B rs1075840 rs2269799 0.72 C 0.325 0.004465 1.36 CATIE SV2B rs1117388 rs2269799 0.55 C 0.325 0.004465 1.36 CATIE SV2B rs2301665 rs2269799 0.59 C 0.325 0.004465 1.36 CATIE SV2B rs8027498 rs2269799 0.72 C 0.325 0.004465 1.36 CATIE SV2B rs3743444 rs2239994 0.50 T 0.113 0.01159 1.53 CATIE SLCO3A1 rs12912997 rs12905912 0.96 A 0.297 0.03912 0.81 CATIE IGF1R rs4965436 rs11634874 0.76 C 0.111 0.02439 1.46 CATIE IGF1R rs11247380 rs7165181 0.55 G 0.194 0.03684 0.78 CATIE IGF1R rs1879613 rs7165181 0.96 G 0.194 0.03684 0.78 CATIE N4BP1 rs1039342 rs8046716 0.61 T 0.500 0.003166 1.34 CATIE N4BP1 rs1120276 rs8046716 0.61 T 0.500 0.003166 1.34 CATIE N4BP1 rs1224 rs8046716 0.61 T 0.500 0.003166 1.34 CATIE N4BP1 rs2354580 rs8046716 1.00 T 0.500 0.003166 1.34 CATIE N4BP1 rs3826176 rs8046716 1.00 T 0.500 0.003166 1.34 CATIE N4BP1 rs9937623 rs8046716 0.59 T 0.500 0.003166 1.34 CATIE NDRG4 rs13333449 rs16960170 0.80 G 0.311 0.02137 1.15 GAIN NDRG4 rs7202037 rs16960170 0.67 G 0.311 0.02137 1.15 GAIN KIAA0182 rs736845 rs736845 N/A A 0.310 0.0005682 1.24 GAIN KIAA0182 rs9940601 rs9940601 N/A A 0.403 0.01452 1.15 GAIN KIAA0182 rs3815794 rs1053328 0.73 A 0.327 0.00984 0.86 GAIN KIAA0182 rs3815794 rs1053328 0.73 T 0.315 0.002786 0.74 CATIE C16orf74 rs11644122 rs11644122 N/A T 0.293 0.03696 0.88 GAIN C16orf74 rs2305357 rs394623 0.55 G 0.403 0.0003797 1.23 GAIN C16orf74 rs373835 rs394623 0.68 G 0.403 0.0003797 1.23 GAIN C16orf74 rs386061 rs394623 0.68 G 0.403 0.0003797 1.23 GAIN PMP22 rs13422 rs230915 0.76 C 0.413 0.03188 1.13 GAIN PMP22 rs230938 rs230915 0.97 C 0.413 0.03188 1.13 GAIN PMP22 rs231021 rs230915 0.55 C 0.413 0.03188 1.13 GAIN FUSSEL18 rs10502880 rs8086549 0.85 C 0.473 0.04802 1.22 CATIE FUSSEL18 rs17785419 rs8086549 0.85 C 0.473 0.04802 1.22 CATIE FUSSEL18 rs2668771 rs8086549 0.64 C 0.473 0.04802 1.22 CATIE FUSSEL18 rs7236105 rs8086549 1.00 C 0.473 0.04802 1.22 CATIE SMAD2 rs12457664 rs1792670 0.85 G 0.445 0.039 0.89 GAIN SMAD2 rs1787176 rs1792670 0.97 G 0.445 0.039 0.89 GAIN SMAD2 rs1792666 rs1792670 0.71 G 0.445 0.039 0.89 GAIN SMAD2 rs1792682 rs1792670 0.94 G 0.445 0.039 0.89 GAIN SMAD2 rs2000709 rs1792670 0.84 G 0.445 0.039 0.89 GAIN SMAD2 rs7228393 rs1792670 0.91 G 0.445 0.039 0.89 GAIN KIAA0427 rs2175565 rs9952398 1.00 C 0.253 0.003642 1.41 CATIE KIAA0427 rs8095199 rs1384227 0.51 C 0.254 0.004491 0.84 GAIN KIAA0427 rs8095199 rs8083702 0.51 C 0.251 0.04846 0.80 CATIE SMAD4 rs12458752 rs1789223 0.53 G 0.365 0.03536 0.89 GAIN SMAD4 rs12958604 rs1789223 0.53 G 0.365 0.03536 0.89 GAIN SMAD4 rs2276163 rs1789223 0.53 G 0.365 0.03536 0.89 GAIN SMAD4 rs2298617 rs1789223 0.53 G 0.365 0.03536 0.89 GAIN SMAD4 rs3764465 rs1789223 0.53 G 0.365 0.03536 0.89 GAIN DCC rs1893572 rs882333 0.76 T 0.326 0.03294 1.26 CATIE BMP7 rs162316 rs162313 0.57 T 0.109 0.01705 0.81 GAIN BMP7 rs162316 rs6127980 0.57 A 0.152 0.03952 1.35 CATIE

Example 2 Novel Markers Associated with Olanzapine Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on olanzapine response was performed using as described in Example 1 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Olanzapine Response and Side Effects:

Tables 2 and 3 report the minor allele frequencies, P values, and ORs for SNPs in Tables B and C, that affect olanzapine response and side effect rates, respectively. Note in Tables 2 and 3 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 2 and 3.

Tables 2 and 3, provide numerous examples of SNP-based alleles that predict altered response to olanzapine. For Table 2, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with decreased susceptibility. For Table 3 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 2 Alleles Affecting Positive Response to Olanzapine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele responders P OR CAMTA1 rs449250 rs277675 0.82 C 0.306 0.01603 0.47 CAMTA1 rs6577393 rs6657847 0.51 T 0.264 0.01963 0.47 CAMTA1 rs6577401 rs4243823 0.53 A 0.361 0.0152 0.48 CAMTA1 rs7554752 rs10864255 0.96 T 0.458 0.0121 2.18 PER3 rs2640909 rs228652 0.70 A 0.361 0.01662 2.21 RP1-21O18.1 rs4661572 rs1000313 0.63 G 0.250 0.01139 2.69 RP1-21O18.1 rs6674129 rs6665012 0.74 G 0.347 0.0226 0.50 KCND3 rs197422 rs197412 0.94 C 0.556 0.02599 1.96 KCND3 rs3738298 rs544941 0.65 T 0.206 0.04845 2.29 DNM3 rs10489730 rs10910966 1.00 C 0.444 0.0202 2.06 DNM3 rs10752946 rs1063412 0.97 G 0.542 0.04115 1.85 DNM3 rs3736791 rs10910966 0.93 C 0.444 0.0202 2.06 DNM3 rs4576686 rs10910966 0.79 C 0.444 0.0202 2.06 SYT14 rs11119426 rs6701631 1.00 T 0.250 0.01892 2.48 DPH3 rs2245708 rs2470508 0.97 T 0.514 0.0172 2.06 DPH3 rs2245721 rs842254 1.00 T 0.343 0.02042 0.49 DPH3 rs842257 rs842254 1.00 T 0.343 0.02042 0.49 DPH3 rs859703 rs842254 1.00 T 0.343 0.02042 0.49 ANK3 rs10733757 rs10761446 0.90 C 0.306 0.01208 2.44 ANK3 rs4568956 rs10761446 0.57 C 0.306 0.01208 2.44 ANK3 rs7907721 rs10761446 0.50 C 0.306 0.01208 2.44 USH1C rs16770 rs2237961 0.92 C 0.042 0.02566 0.26 NAV2 rs2585788 rs2625312 0.84 A 0.292 0.04703 2.02 DAAM1 rs10143918 rs6573250 0.69 T 0.542 0.00853 2.22 DAAM1 rs1252989 rs7143953 0.67 T 0.286 0.03629 0.51 DAAM1 rs1253005 rs7143953 0.66 T 0.286 0.03629 0.51 DAAM1 rs1268579 rs17096088 0.60 G 0.069 0.03473 0.34 DAAM1 rs4127823 rs12589351 0.61 C 0.528 0.03651 1.88 DAAM1 rs4901909 rs7143953 0.60 T 0.286 0.03629 0.51 DAAM1 rs8022614 rs7143953 0.93 T 0.286 0.03629 0.51 DAAM1 rs941884 rs7143953 0.51 T 0.286 0.03629 0.51 GPR135 rs10136708 rs1253170 0.67 T 0.556 0.01391 2.10 GPR135 rs10138199 rs1253170 0.54 T 0.556 0.01391 2.10 GPR135 rs1253181 rs1253170 0.74 T 0.556 0.01391 2.10 GPR135 rs17255731 rs1273156 0.62 T 0.597 0.03629 1.88 GPR135 rs4898989 rs1253170 0.54 T 0.556 0.01391 2.10 GPR135 rs9323348 rs1253170 0.54 T 0.556 0.01391 2.10 EML1 rs11160553 rs11623084 0.88 C 0.485 0.0387 1.91 EML1 rs12433613 rs11623084 0.77 C 0.485 0.0387 1.91 EML1 rs2250718 rs10150225 0.53 T 0.667 0.01353 2.14 EML1 rs2273707 rs10150225 1.00 T 0.667 0.01353 2.14 EML1 rs6575751 rs11623084 0.88 C 0.485 0.0387 1.91 HERC2 rs1635168 rs8041209 0.87 T 0.028 0.02867 0.21 HERC2 rs2238289 rs8041209 0.51 T 0.028 0.02867 0.21 HERC2 rs7495174 rs8041209 0.58 T 0.028 0.02867 0.21 UNC13C rs12910912 rs12900128 0.52 C 0.361 0.01107 2.34 NEDD4 rs2303579 rs10518831 0.51 G 0.194 0.02723 2.61 NEDD4 rs2303580 rs10518831 0.51 G 0.194 0.02723 2.61 SV2B rs11630131 rs1002556 0.83 C 0.250 0.01139 2.69 SV2B rs2073967 rs1002556 0.51 C 0.250 0.01139 2.69 SLCO3A1 rs1517618 rs207954 0.72 T 0.167 0.00355 0.35 SLCO3A1 rs2176452 rs8027160 0.58 G 0.444 0.02815 1.98 IGF1R rs4966020 rs11633717 0.88 C 0.236 0.02174 0.47 IGF1R rs7174918 rs11633717 0.88 C 0.236 0.02174 0.47 IGF1R rs8038015 rs11633717 0.82 C 0.236 0.02174 0.47 NDRG4 rs1058132 rs1058132 N/A T 0.371 0.02093 2.15 NDRG4 rs2271948 rs1058132 0.74 T 0.371 0.02093 2.15 NDRG4 rs2280397 rs1058132 0.92 T 0.371 0.02093 2.15 C16orf74 rs2305357 rs442069 0.77 G 0.250 0.00821 0.42 C16orf74 rs373835 rs442069 0.93 G 0.250 0.00821 0.42 C16orf74 rs386061 rs442069 1.00 G 0.250 0.00821 0.42 C16orf74 rs386061 rs386061 N/A C 0.278 0.01847 0.47 KIAA0427 rs8094634 rs1023943 0.72 T 0.208 0.0413 0.49 SMAD7 rs11874392 rs12953717 0.65 T 0.528 0.02717 1.95 SMAD7 rs736839 rs2337153 0.73 A 0.486 0.00224 2.59 DYM rs498929 rs577979 0.96 A 0.125 0.01752 0.38 DYM rs833503 rs577979 0.53 A 0.125 0.01752 0.38 NDRG4 rs1058132 rs1058132 N/A T 0.371 0.02093 2.15 UNC13C rs12910912 rs12910912 N/A G 0.250 0.01139 2.69 SV2B rs11630131 rs11630131 N/A A 0.222 0.01349 2.78

TABLE 3 Alleles Affecting Negative Side Effects for Olanzapine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR CAMTA1 rs1417986 rs2301488 0.54 T 0.630 0.03409 2.08 CAMTA1 rs7554752 rs17030082 0.63 A 0.239 0.02475 0.43 DNM3 rs10752946 rs1063412 0.97 G 0.283 0.009837 0.39 DNM3 rs13932 rs9425606 0.75 G 0.130 0.007451 0.30 DNM3 rs2206543 rs6690848 0.52 G 0.500 0.03358 2.06 DNM3 rs4075021 rs12075807 0.71 G 0.565 0.03158 2.09 DNM3 rs4382763 rs4072117 1.00 C 0.326 0.01406 2.55 DNM3 rs6701033 rs6690848 0.52 G 0.500 0.03358 2.06 DNM3 rs965051 rs6690848 0.52 G 0.500 0.03358 2.06 RHOG rs11030008 rs11030008 N/A G 0.522 0.01711 2.25 RHOG rs1451722 rs11030008 0.76 G 0.522 0.01711 2.25 RHOG rs11030008 rs11030008 N/A G 0.522 0.01711 2.25 OTOG rs1003490 rs11024348 0.77 T 0.370 0.003588 2.93 OTOG rs10832824 rs11024348 0.52 T 0.370 0.003588 2.93 OTOG rs11024357 rs869108 0.85 G 0.370 0.0001953 4.10 OTOG rs11024358 rs869108 0.85 G 0.370 0.0001953 4.10 OTOG rs2023483 rs11024348 0.50 T 0.370 0.003588 2.93 OTOG rs11024357 rs11024357 N/A C 0.370 0.0001953 4.10 NAV2 rs2585788 rs2625312 0.84 A 0.065 0.00435 0.19 NAV2 rs6483629 rs12099330 0.59 T 0.261 0.0278 2.47 NAV2 rs7125647 rs2119981 0.61 A 0.238 0.004283 0.33 ULK1 rs11616018 rs10794440 0.51 G 0.087 0.02249 0.30 ULK1 rs9652059 rs10794440 0.55 G 0.087 0.02249 0.30 TTC5 rs1953552 rs11623837 0.60 G 0.261 0.02693 0.44 TEP1 rs1713418 rs1713419 1.00 G 0.283 0.04278 0.48 DAAM1 rs4127823 rs12589351 0.61 C 0.304 0.04536 0.49 GPR135 rs10136708 rs1253170 0.67 T 0.304 0.0307 0.46 GPR135 rs10138199 rs1253170 0.54 T 0.304 0.0307 0.46 GPR135 rs1253181 rs1253170 0.74 T 0.304 0.0307 0.46 GPR135 rs4898989 rs1253170 0.54 T 0.304 0.0307 0.46 GPR135 rs9323348 rs1253170 0.54 T 0.304 0.0307 0.46 RTN1 rs10145080 rs12878097 0.55 C 0.087 0.01469 0.28 RTN1 rs12717467 rs17731838 0.52 T 0.087 0.01821 0.29 RTN1 rs17310036 rs1957311 0.79 A 0.182 0.008994 0.34 EVL rs4905933 rs10148930 0.85 A 0.283 0.004807 0.36 EVL rs726514 rs10148930 0.85 A 0.283 0.004807 0.36 HERC2 rs1635168 rs2346050 0.87 C 0.152 0.03438 3.05 HERC2 rs2238289 rs2346050 0.51 C 0.152 0.03438 3.05 HERC2 rs7495174 rs2346050 0.58 C 0.152 0.03438 3.05 UNC13C rs11856476 rs8024165 0.84 T 0.413 0.01984 2.28 UNC13C rs12594549 rs2115820 0.90 G 0.068 0.04824 0.30 UNC13C rs12914912 rs8024165 0.63 T 0.413 0.01984 2.28 UNC13C rs4776216 rs8024165 0.52 T 0.413 0.01984 2.28 NEDD4 rs17238461 rs9972348 0.57 G 0.326 0.04861 2.10 Gcom1 rs1908202 rs2470360 0.64 T 0.413 0.03002 2.15 GRINL1A rs2069133 rs1873993 0.84 G 0.522 0.02761 2.12 ADAM10 rs3764196 rs7164844 0.51 C 0.043 0.02586 0.21 N4BP1 rs1039342 rs8046716 0.61 T 0.348 0.04956 0.50 N4BP1 rs1120276 rs8046716 0.61 T 0.348 0.04956 0.50 N4BP1 rs1224 rs8046716 0.61 T 0.348 0.04956 0.50 N4BP1 rs2354580 rs8046716 1.00 T 0.348 0.04956 0.50 N4BP1 rs3826176 rs8046716 1.00 T 0.348 0.04956 0.50 N4BP1 rs9937623 rs8046716 0.59 T 0.348 0.04956 0.50 CDH8 rs4636897 rs11641508 1.00 A 0.023 0.03974 0.15 BEAN rs4247350 rs4247350 N/A C 0.174 0.02628 0.40 KIAA0513 rs4783121 rs4783121 N/A A 0.087 0.01362 6.76 KIAA0182 rs736845 rs736845 N/A T 0.182 0.04535 0.43 PMP22 rs13422 rs230911 0.59 A 0.326 0.03223 0.47 PMP22 rs230938 rs230911 0.61 A 0.326 0.03223 0.47 PMP22 rs231018 rs230911 0.75 A 0.326 0.03223 0.47 PMP22 rs231021 rs230911 0.78 A 0.326 0.03223 0.47 FUSSEL18 rs892583 rs7244178 0.68 T 0.217 0.009474 0.37 FUSSEL18 rs892583 rs892583 N/A G 0.205 0.04865 0.45 DCC rs12457407 rs11876282 0.65 G 0.591 0.04231 2.02 DCC rs1393331 rs17506154 1.00 C 0.587 0.01453 2.30 DCC rs4940251 rs17506154 0.53 C 0.587 0.01453 2.30 DCC rs6508145 rs1031062 0.67 G 0.065 0.01905 0.25 DCC rs6508235 rs2036415 0.58 G 0.548 0.03016 2.14 DCC rs7506904 rs11876282 0.58 G 0.591 0.04231 2.02 DCC rs8097413 rs10502969 1.00 C 0.196 0.01433 3.21 DCC rs950278 rs11876282 0.56 G 0.591 0.04231 2.02 TMEPAI rs427278 rs203386 0.51 C 0.591 0.0107 2.43

Example 3 Novel Markers Associated with Risperidone Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on risperidone response was performed using as described in Example 2 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Risperidone Response and Side Effects:

Tables 4 and 5 report the minor allele frequencies, P values, and ORs for SNPs, in Tables B and C that affect risperidone response and side effect rates, respectively. Note in Tables 4 and 5 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 4 and 5.

Tables 4 and 5, provide numerous examples of SNP-based alleles that predict altered response to risperidone. For Table 4, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with lesser clinical improvement. For Table 5 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 4 Alleles Affecting Positive Response to Risperidone Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele responders P OR RERE rs12136689 rs10779702 0.76 A 0.266 0.03124 0.49 RERE rs8627 rs10779702 0.52 A 0.266 0.03124 0.49 DNM3 rs4382763 rs6701929 0.84 C 0.156 0.04448 0.46 RABGAP1L rs6425302 rs1793319 0.59 A 0.500 0.02472 2.00 CACNA1E rs199960 rs3856093 0.51 C 0.281 0.04197 0.51 CACNA1E rs3856090 rs3856093 1.00 C 0.281 0.04197 0.51 ANK3 rs2393607 rs2393602 0.56 C 0.484 0.04133 1.88 PTPN5 rs4345940 rs4757718 0.53 G 0.219 0.04081 0.49 SYT13 rs11038382 rs7943596 1.00 C 0.194 0.03562 0.46 SYT13 rs2863182 rs7943596 0.84 C 0.194 0.03562 0.46 SYT13 rs4992029 rs7943596 0.61 C 0.194 0.03562 0.46 CHFR rs3741494 rs3741494 N/A T 0.194 0.0429 2.40 JPH4 rs12897422 rs12897422 N/A A 0.188 0.00592 3.58 DAAM1 rs4898983 rs2099636 0.96 A 0.203 0.03748 0.48 NEDD4 rs2303579 rs10518831 0.51 G 0.266 0.002306 3.31 NEDD4 rs2303580 rs10518831 0.51 G 0.266 0.002306 3.31 GRINL1A rs4774275 rs1873995 0.51 G 0.359 0.0403 0.53 Gcom1 rs986868 rs11071337 0.59 C 0.609 0.01971 2.05 SLCO3A1 rs2286355 rs11630872 0.85 T 0.469 0.03077 1.96 N4BP1 rs1039342 rs2129243 1.00 T 0.258 0.03604 0.49 N4BP1 rs1120276 rs2129243 1.00 T 0.258 0.03604 0.49 N4BP1 rs1224 rs2129243 1.00 T 0.258 0.03604 0.49 N4BP1 rs2354580 rs2129243 0.61 T 0.258 0.03604 0.49 N4BP1 rs3826176 rs2129243 0.61 T 0.258 0.03604 0.49 N4BP1 rs9937623 rs2129243 0.96 T 0.258 0.03604 0.49 CBLN1 rs11076478 rs12598711 0.89 G 0.422 0.01435 2.19 CBLN1 rs9935379 rs12598711 0.72 G 0.422 0.01435 2.19 CDH8 rs1397131 rs9925201 0.76 G 0.594 0.02591 1.98 CDH8 rs8057338 rs9925201 0.79 G 0.594 0.02591 1.98 CDH8 rs9302540 rs9925201 0.79 G 0.594 0.02591 1.98 CDH8 rs9302540 rs9302540 N/A G 0.563 0.04052 1.88 SMAD7 rs736839 rs2337153 0.73 A 0.563 0.003133 2.49 DYM rs8096141 rs7239949 0.87 G 0.113 0.04631 3.18 TMEPAI rs427278 rs203386 0.51 C 0.258 0.03803 0.50

TABLE 5 Alleles Affecting Negative Side Effects for Risperidone Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR CAMTA1 rs228651 rs11121029 0.51 A 0.000 0.009148 0.00 PER3 rs2640909 rs228652 0.70 A 0.542 0.01808 2.77 RP1-21O18.1 rs2073091 rs761288 0.69 C 0.542 0.004869 3.34 RP1-21O18.1 rs4661572 rs761288 0.56 C 0.542 0.004869 3.34 SLC6A17 rs12133992 rs2784140 0.90 G 0.708 0.0434 2.54 SLC6A17 rs534276 rs2784140 0.60 G 0.708 0.0434 2.54 KCND3 rs197422 rs197412 0.94 C 0.167 0.01199 0.26 DNM3 rs13932 rs9425606 0.75 G 0.500 0.00697 3.21 DNM3 rs4382763 rs12410416 1.00 C 0.417 0.008488 3.20 DNM3 rs4382763 rs4382763 N/A A 0.375 0.0302 2.68 KCNH1 rs1770213 rs1777264 0.94 C 0.000 0.01943 0.00 DPH3 rs2245708 rs842252 1.00 A 0.583 0.02254 2.68 EXOC2 rs2493049 rs12154040 0.54 C 0.667 0.00848 3.21 ANK3 rs1551684 rs1551683 1.00 T 0.292 0.007594 3.71 ANK3 rs1551684 rs1551684 N/A A 0.250 0.03112 3.04 DEAF1 rs4963145 rs936465 0.53 G 0.182 0.002149 0.20 DEAF1 rs6597990 rs10902190 0.58 T 0.083 0.01958 0.20 DEAF1 rs6597996 rs936465 0.58 G 0.182 0.002149 0.20 DEAF1 rs936465 rs936465 N/A G 0.182 0.002149 0.20 PTPN5 rs4345940 rs7117716 0.97 T 0.583 0.004185 3.42 PTPN5 rs7932938 rs7117716 0.54 T 0.583 0.004185 3.42 SLC17A6 rs11026532 rs1155331 0.96 T 0.042 0.01523 0.12 SYT13 rs4992029 rs7117240 0.55 C 0.625 0.0497 2.37 SYT13 rs8929 rs7117240 0.54 C 0.625 0.0497 2.37 RTN4RL2 rs2511986 rs2649667 0.87 T 0.000 0.006313 0.00 KIAA1853 rs7297606 rs4075945 1.00 T 0.333 0.0007673 4.88 RIMBP2 rs2277356 rs4759462 0.76 T 0.292 0.0369 2.77 NDRG2 rs1243444 rs1243446 0.58 G 0.167 0.01347 0.26 NDRG2 rs1243446 rs1243446 N/A G 0.167 0.01347 0.26 DAAM1 rs17833769 rs1958180 0.95 G 0.083 0.03279 0.22 DAAM1 rs1958180 rs1958180 N/A G 0.083 0.03279 0.22 GPR135 rs10136708 rs1253103 0.54 C 0.250 0.04172 0.38 GPR135 rs10138199 rs1253103 0.88 C 0.250 0.04172 0.38 GPR135 rs1253181 rs1253103 0.71 C 0.250 0.04172 0.38 GPR135 rs17255731 rs1253103 0.57 C 0.250 0.04172 0.38 GPR135 rs4898989 rs1253103 0.88 C 0.250 0.04172 0.38 GPR135 rs9323348 rs1253103 0.88 C 0.250 0.04172 0.38 HERC2 rs11074322 rs6497272 1.00 G 0.083 0.003758 15.55 HERC2 rs1635168 rs6497292 0.87 G 0.208 0.002843 5.40 HERC2 rs2238289 rs6497292 0.51 G 0.208 0.002843 5.40 HERC2 rs7495174 rs6497292 0.58 G 0.208 0.002843 5.40 UNC13C rs16974691 rs16974712 0.96 T 0.042 0.04931 0.16 SV2B rs1117388 rs1117387 1.00 T 0.042 0.03508 0.15 SV2B rs3743444 rs1117387 0.57 T 0.042 0.03508 0.15 SLCO3A1 rs2176452 rs8027160 0.58 G 0.500 0.01784 2.78 IGF1R rs11247380 rs3743258 0.93 A 0.500 0.02156 2.70 IGF1R rs1879613 rs3743258 0.51 A 0.500 0.02156 2.70 CBLN1 rs3743777 rs8052939 0.89 G 0.167 0.03498 3.62 CDH8 rs11075445 rs13336134 0.80 C 0.583 0.02155 2.72 CDH8 rs1369918 rs13336134 0.80 C 0.583 0.02155 2.72 CDH8 rs1978796 rs13336134 0.80 C 0.583 0.02155 2.72 CDH8 rs6498807 rs13336134 1.00 C 0.583 0.02155 2.72 CDH8 rs9939991 rs13336134 0.55 C 0.583 0.02155 2.72 CDH11 rs35144 rs40115 1.00 T 0.500 0.01784 2.78 CDH11 rs35148 rs40115 0.68 T 0.500 0.01784 2.78 CDH11 rs35186 rs40115 0.56 T 0.500 0.01784 2.78 CDH11 rs35195 rs35195 N/A A 0.500 0.01938 2.74 CDH11 rs35144 rs35144 N/A C 0.500 0.02156 2.70 DCC rs1393331 rs1502229 0.84 G 0.136 0.01594 0.24 DCC rs4940251 rs1502229 0.59 G 0.136 0.01594 0.24 DCC rs6508235 rs1502229 0.58 G 0.136 0.01594 0.24

Example 4 Novel Markers Associated with Quetiapine Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on quetiapine response was performed using as described in Example 2 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Quetiapine Response and Side Effects:

Tables 6 and 7 report the minor allele frequencies, P values, and ORs for SNPs, in Tables B and C that affect quetiapine response and side effect rates, respectively. Note in Tables 6 and 7 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 6 and 7.

Tables 6 and 7, provide numerous examples of SNP-based alleles that predict altered response to quetiapine. For Table 6, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with lesser clinical improvement. For Table 7 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 6 Alleles Affecting Positive Response to Quetiapine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele responders P OR RP1-21O18.1 rs7546786 rs7546786 N/A C 0.340 0.03888 2.12 CACNA1E rs638132 rs678643 0.86 G 0.300 0.04268 2.14 CAMK1G rs2356933 rs6683256 1.00 T 0.208 0.02384 0.42 EXOC2 rs2294660 rs1150856 0.55 C 0.280 0.03354 2.28 EXOC2 rs998777 rs17135931 0.66 A 0.300 0.0313 2.26 YPEL4 rs1798177 rs1798173 0.84 T 0.280 0.01513 0.42 YPEL4 rs7947357 rs1798173 0.84 T 0.280 0.01513 0.42 CTNND1 rs10896644 rs1786438 0.97 T 0.313 0.007608 0.40 CTNND1 rs11570176 rs1786438 0.97 T 0.313 0.007608 0.40 CTNND1 rs2156638 rs1786438 1.00 T 0.313 0.007608 0.40 CTNND1 rs652908 rs1786438 1.00 T 0.313 0.007608 0.40 CTNND1 rs708228 rs576859 1.00 A 0.458 0.01184 2.36 KIAA1853 rs7297606 rs4075945 1.00 T 0.200 0.009895 3.30 STX2 rs1236 rs10848205 1.00 T 0.580 0.02392 2.11 STX2 rs4759517 rs10848205 0.81 T 0.580 0.02392 2.11 STX2 rs6486600 rs10848205 0.79 T 0.580 0.02392 2.11 STX2 rs6486602 rs10848205 0.81 T 0.580 0.02392 2.11 DACT1 rs464582 rs464582 N/A C 0.520 0.03106 2.04 DAAM1 rs10143918 rs10873113 0.58 T 0.280 0.0335 2.29 DAAM1 rs11626926 rs4901921 0.85 T 0.563 0.01108 2.36 DAAM1 rs12147707 rs10873113 0.86 T 0.280 0.0335 2.29 DAAM1 rs17095965 rs10873113 0.86 T 0.280 0.0335 2.29 DAAM1 rs4127823 rs4901921 0.60 T 0.563 0.01108 2.36 GPR135 rs10136708 rs1253103 0.54 C 0.280 0.04103 0.49 GPR135 rs10138199 rs1253103 0.88 C 0.280 0.04103 0.49 GPR135 rs1253181 rs1253103 0.71 C 0.280 0.04103 0.49 GPR135 rs17255731 rs1253103 0.57 C 0.280 0.04103 0.49 GPR135 rs4898989 rs1253103 0.88 C 0.280 0.04103 0.49 GPR135 rs9323348 rs1253103 0.88 C 0.280 0.04103 0.49 RTN1 rs10145080 rs17731838 0.65 T 0.100 0.008147 0.28 RTN1 rs12717467 rs17731838 0.52 T 0.100 0.008147 0.28 RTN1 rs17310036 rs17731838 0.81 T 0.100 0.008147 0.28 EML1 rs2273704 rs12590861 0.61 C 0.500 0.001846 2.84 EML1 rs7143905 rs12590861 0.70 C 0.500 0.001846 2.84 EML1 rs2273704 rs2273704 N/A C 0.520 0.01052 2.34 EVL rs3206354 rs12431406 0.58 C 0.140 0.007758 4.53 UNC13C rs9920139 rs1961635 0.55 T 0.200 0.03866 2.52 UNC13C rs9920150 rs1961635 0.61 T 0.200 0.03866 2.52 Gcom1 rs986868 rs11071337 0.59 C 0.640 0.003757 2.64 AKAP13 rs1053992 rs12440599 0.61 T 0.460 0.04784 1.94 AKAP13 rs11073502 rs2291048 0.53 A 0.174 0.03896 0.42 AKAP13 rs2061821 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs2061822 rs12440599 0.89 T 0.460 0.04784 1.94 AKAP13 rs2061824 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs338523 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs4075254 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs4075256 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs4842895 rs12440599 0.76 T 0.460 0.04784 1.94 AKAP13 rs4843074 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs4843075 rs12440599 0.96 T 0.460 0.04784 1.94 AKAP13 rs7162168 rs12440599 0.96 T 0.460 0.04784 1.94 SV2B rs1075840 rs1079535 0.87 A 0.480 0.02175 2.15 SV2B rs2301665 rs1079535 0.74 A 0.480 0.02175 2.15 SV2B rs8027498 rs1079535 0.60 A 0.480 0.02175 2.15 RGMA rs13167 rs11074130 0.59 T 0.180 0.003617 4.30 IGF1R rs11247380 rs1521481 0.73 C 0.240 0.02095 0.43 IGF1R rs2684808 rs951715 0.51 G 0.260 0.02238 0.44 IGF1R rs8030950 rs1879612 0.66 C 0.188 0.02051 0.40 BEAN rs4247350 rs11645280 0.61 G 0.417 0.02122 2.22 FUSSEL18 rs892583 rs2164098 0.95 G 0.420 0.01515 2.30 FUSSEL18 rs892583 rs892583 N/A G 0.391 0.04015 2.08 KIAA0427 rs2175565 rs12456253 0.68 G 0.220 0.03731 0.46 KIAA0427 rs4939813 rs1994559 0.53 A 0.240 0.006482 3.18 KIAA0427 rs937021 rs12458062 0.52 T 0.600 0.03871 1.98 DCC rs12457407 rs7506909 0.93 A 0.520 0.01922 2.17 DCC rs1393331 rs17504520 0.78 G 0.587 0.02781 2.12 DCC rs2229080 rs9966074 0.60 T 0.340 0.01745 0.45 DCC rs4940251 rs7506909 0.67 A 0.520 0.01922 2.17 DCC rs6508145 rs1454731 0.82 C 0.320 0.01176 2.57 DCC rs6508235 rs10515959 0.77 T 0.340 0.03565 2.13 DCC rs7506904 rs7506909 0.83 A 0.520 0.01922 2.17 DCC rs950278 rs9966074 0.87 T 0.340 0.01745 0.45

TABLE 7 Alleles Affecting Negative Side Effects for Quetiapine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR CAMTA1 rs845197 rs845265 0.91 T 0.095 0.02848 0.31 RERE rs7530745 rs6577499 1.00 G 0.273 0.03893 0.46 RERE rs7554486 rs6577499 0.65 G 0.273 0.03893 0.46 SLC16A4 rs10857820 rs3768458 0.65 T 0.318 0.04016 0.48 SLC16A4 rs1334882 rs3768458 1.00 T 0.318 0.04016 0.48 KCNA10 rs3768456 rs7543509 1.00 G 0.182 0.0001722 8.11 CACNA1E rs17494681 rs17494681 N/A T 0.296 0.0268 2.40 CACNA1E rs3856090 rs7534913 0.50 G 0.381 0.04817 0.50 KCNH1 rs4620600 rs4951495 0.79 A 0.068 0.01863 0.25 ANK3 rs2393596 rs10761451 0.78 G 0.159 0.04472 0.41 DEAF1 rs7109335 rs7123677 0.84 T 0.227 0.03893 2.46 DEAF1 rs7121608 rs7123677 0.92 T 0.227 0.03893 2.46 DEAF1 rs7935419 rs7123677 0.92 T 0.227 0.03893 2.46 USH1C rs10766408 rs2041032 0.51 T 0.568 0.01695 2.27 USH1C rs2041027 rs2041032 0.78 T 0.568 0.01695 2.27 USH1C rs2237957 rs2041032 0.69 T 0.568 0.01695 2.27 KCNC1 rs10766434 rs2299637 0.66 A 0.455 0.01364 2.37 KCNC1 rs2299637 rs2299637 N/A A 0.455 0.01364 2.37 KCNC1 rs757514 rs2299637 0.66 A 0.455 0.01364 2.37 NAV2 rs10833202 rs11025328 0.61 A 0.727 0.001805 3.13 SLC17A6 rs11026523 rs1562445 0.79 A 0.068 0.008164 0.22 SLC17A6 rs1155821 rs1562445 0.96 A 0.068 0.008164 0.22 SLC17A6 rs2078352 rs1562445 1.00 A 0.068 0.008164 0.22 SLC17A6 rs2246710 rs1562445 1.00 A 0.068 0.008164 0.22 SLC17A6 rs2078352 rs2078352 N/A T 0.068 0.01127 0.23 LRRC4C rs10837367 rs10501225 0.69 A 0.023 0.03099 0.14 RTN4RL2 rs2511986 rs2649667 0.87 T 0.409 0.04498 2.04 KIAA1853 rs7297606 rs4075945 1.00 T 0.023 0.04399 0.16 CHFR rs2306536 rs11147101 1.00 G 0.091 0.04245 0.34 CHFR rs4758954 rs11147101 1.00 G 0.091 0.04245 0.34 GPR135 rs10136708 rs1253103 0.54 C 0.546 0.02737 2.13 GPR135 rs10138199 rs2774052 0.72 A 0.614 0.01223 2.38 GPR135 rs1253181 rs2774052 0.89 A 0.614 0.01223 2.38 GPR135 rs17255731 rs2774052 0.70 A 0.614 0.01223 2.38 GPR135 rs4898989 rs2774052 0.72 A 0.614 0.01223 2.38 GPR135 rs9323348 rs2774052 0.72 A 0.614 0.01223 2.38 EML1 rs2273704 rs12590861 0.61 C 0.182 0.02262 0.39 EML1 rs7143905 rs12590861 0.70 C 0.182 0.02262 0.39 EVL rs1190954 rs1190967 0.96 G 0.182 0.02583 0.40 EVL rs1190956 rs1190967 0.60 G 0.182 0.02583 0.40 EVL rs1190974 rs1190967 0.96 G 0.182 0.02583 0.40 WDR25 rs10873518 rs7492607 0.97 C 0.523 0.01011 2.43 UNC13C rs11856476 rs8023723 0.53 G 0.477 0.04506 2.00 UNC13C rs12914912 rs8023723 0.86 G 0.477 0.04506 2.00 UNC13C rs4776216 rs8023723 1.00 G 0.477 0.04506 2.00 NEDD4 rs17238461 rs2175104 0.53 A 0.048 0.04132 0.24 AKAP13 rs338556 rs870689 0.91 A 0.136 0.009364 4.58 KLHL25 rs2430838 rs870689 1.00 A 0.136 0.009364 4.58 KLHL25 rs2430838 rs2430838 N/A T 0.114 0.03635 3.67 SLCO3A1 rs2176452 rs8027160 0.58 G 0.136 0.01379 0.33 NETO2 rs11859615 rs9928466 0.85 C 0.000 0.03539 0.00 NETO2 rs16952126 rs9928466 0.85 C 0.000 0.03539 0.00 NETO2 rs7184206 rs9928466 1.00 C 0.000 0.03539 0.00 NETO2 rs9923731 rs9928466 0.85 C 0.000 0.03539 0.00 ZNF423 rs12924119 rs2883977 0.51 C 0.341 0.005838 2.86 NDRG4 rs13333449 rs16960170 0.80 C 0.341 0.03824 2.18 NDRG4 rs7202037 rs16960170 0.67 C 0.341 0.03824 2.18 CDH8 rs1397131 rs16964164 0.90 T 0.523 0.02822 2.13 CDH8 rs8057338 rs16964164 0.93 T 0.523 0.02822 2.13 CDH8 rs9302540 rs16964164 0.93 T 0.523 0.02822 2.13 CDH11 rs35144 rs40115 1.00 T 0.477 0.03109 2.12 CDH11 rs35148 rs40115 0.68 T 0.477 0.03109 2.12 CDH11 rs35186 rs40115 0.56 T 0.477 0.03109 2.12 CDH11 rs35195 rs35195 N/A A 0.477 0.04506 2.00 CDH11 rs35186 rs35186 N/A T 0.619 0.03313 2.13 BEAN rs4247350 rs1063438 0.59 A 0.182 0.006152 0.32 KIAA0427 rs2306514 rs2306514 N/A G 0.500 0.02294 2.19 KIAA0427 rs752151 rs2337099 0.83 G 0.136 0.003807 5.76 KIAA0427 rs937021 rs12458062 0.52 T 0.341 0.044 0.49 TMEPAI rs427278 rs203386 0.51 C 0.250 0.02943 0.44

Example 5 Novel Markers Associated with Perphenazine Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on perphenazine response was performed using as described in Example 2 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Perphenazine Response and Side Effects:

Tables 8 and 9 report the minor allele frequencies, P values, and ORs for SNPs, in Tables B and C that affect perphenazine response and side effect rates, respectively. Note in Tables 8 and 9 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 8 and 9.

Tables 8 and 9, provide numerous examples of SNP-based alleles that predict altered response to perphenazine For Table 8, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with lesser clinical improvement. For Table 9 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 8 Alleles Affecting Positive Response to Perphenazine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele responders P OR CAMTA1 rs6577393 rs6657847 0.51 T 0.391 0.04251 2.04 CAMTA1 rs6577401 rs6698901 0.59 G 0.641 0.03272 2.03 RP1-21O18.1 rs4661572 rs4501834 0.60 C 0.242 0.02391 2.68 CACNA1E rs199960 rs1953690 0.81 A 0.422 0.04061 2.01 CAMK1G rs9430004 rs9430004 N/A T 0.563 0.01262 2.27 KCNH1 rs1393026 rs7529770 0.52 G 0.323 0.01484 0.44 KCNH1 rs1770220 rs1777256 1.00 A 0.266 0.007082 0.39 ANK3 rs3750800 rs3750800 N/A A 0.281 0.03529 0.48 TOLLIP rs3168046 rs2672812 0.85 G 0.375 0.03841 0.51 TOLLIP rs3750920 rs2672812 0.85 G 0.375 0.03841 0.51 HCCA2 rs7396514 rs10734456 0.55 C 0.141 0.03102 0.41 DUSP8 rs10734456 rs10734456 N/A C 0.141 0.03102 0.41 DUSP8 rs902224 rs10734456 0.74 C 0.141 0.03102 0.41 KCNC1 rs10766434 rs10766426 0.78 G 0.484 0.01735 2.21 KCNC1 rs2299637 rs10766426 0.56 G 0.484 0.01735 2.21 KCNC1 rs757514 rs10766426 0.78 G 0.484 0.01735 2.21 SERGEF rs172424 rs2299628 0.65 G 0.281 0.02554 0.46 SERGEF rs211130 rs2299628 0.65 G 0.281 0.02554 0.46 SERGEF rs211137 rs2299628 0.65 G 0.281 0.02554 0.46 SERGEF rs211146 rs2299628 1.00 G 0.281 0.02554 0.46 SERGEF rs2283233 rs2299628 1.00 G 0.281 0.02554 0.46 SERGEF rs1528 rs1528 N/A C 0.188 0.007483 4.11 SERGEF rs2283233 rs2283233 N/A C 0.274 0.02958 0.47 NAV2 rs2585788 rs2625312 0.84 A 0.203 0.04449 0.47 SLC17A6 rs1979072 rs11026546 1.00 A 0.250 0.009104 3.15 SLC17A6 rs1979073 rs11026546 1.00 A 0.250 0.009104 3.15 SLC17A6 rs2593644 rs11026546 0.88 A 0.250 0.009104 3.15 SLC17A6 rs764021 rs721840 0.97 C 0.242 0.02368 0.44 PHACS rs3107275 rs3134907 0.79 C 0.203 0.02318 0.43 KIAA1853 rs1568923 rs10851061 0.58 G 0.188 0.03528 0.45 KIAA1545 rs10870551 rs4418881 1.00 G 0.234 0.0243 0.44 KIAA1545 rs4883513 rs4883513 N/A T 0.233 0.01119 0.40 RTN1 rs17255975 rs1884737 0.75 G 0.234 0.01716 2.89 UNC13C rs11856476 rs8024165 0.84 T 0.438 0.01674 2.27 UNC13C rs12914912 rs8024165 0.63 T 0.438 0.01674 2.27 UNC13C rs4776216 rs8024165 0.52 T 0.438 0.01674 2.27 UNC13C rs9920139 rs9920150 0.91 G 0.047 0.04211 0.28 UNC13C rs9920150 rs9920150 N/A G 0.047 0.04211 0.28 NEDD4 rs1509408 rs1509408 N/A C 0.281 0.03119 2.38 GRINL1A rs16977631 rs11638184 0.52 A 0.063 0.004306 0.22 GCOM1 rs2733619 rs2733619 N/A C 0.016 0.04231 0.15 AKAP13 rs338556 rs8025135 0.71 G 0.297 0.0149 2.63 KLHL25 rs2430838 rs8025135 0.64 G 0.297 0.0149 2.63 SLCO3A1 rs2286355 rs11630872 0.85 T 0.422 0.01222 2.39 SLCO3A1 rs6496893 rs11638063 1.00 A 0.047 0.04211 0.28 CBLN1 rs11076478 rs893175 0.53 C 0.484 0.007589 2.46 CBLN1 rs3743777 rs8052939 0.89 G 0.094 0.01269 9.62 CBLN1 rs9935379 rs893175 0.69 C 0.484 0.007589 2.46 CDH11 rs35144 rs35164 0.68 T 0.145 0.04592 0.43 CDH11 rs35148 rs35164 1.00 T 0.145 0.04592 0.43 BEAN rs11644279 rs11075635 0.59 C 0.266 0.02787 2.47 COX10 rs4792434 rs8077302 0.55 G 0.597 0.01289 2.28 COX10 rs8077302 rs8077302 N/A G 0.597 0.01289 2.28 KATNAL2 rs2247221 rs4986203 0.53 A 0.468 0.04996 1.95 KATNAL2 rs2571030 rs4986203 0.53 A 0.468 0.04996 1.95 KATNAL2 rs9961383 rs4986203 0.53 A 0.468 0.04996 1.95 FUSSEL18 rs10502880 rs11082575 0.55 G 0.339 0.01242 0.43 FUSSEL18 rs17785419 rs11082575 0.55 G 0.339 0.01242 0.43 FUSSEL18 rs2668771 rs9965170 0.56 A 0.406 0.02724 0.49 FUSSEL18 rs7236105 rs9965170 0.88 A 0.406 0.02724 0.49 DCC rs12457407 rs9949949 0.83 A 0.453 0.03236 2.06 DCC rs1893572 rs7228674 0.77 T 0.156 0.03404 0.42 DCC rs4940251 rs9949949 0.82 A 0.453 0.03236 2.06 DCC rs7506904 rs9949949 0.93 A 0.453 0.03236 2.06 BMP7 rs230198 rs230191 0.97 T 0.406 0.02724 0.49 TMEPAI rs6015068 rs6015068 N/A T 0.484 0.01161 2.33

TABLE 9 Alleles Affecting Negative Side Effects for Perphenazine Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR CAMTA1 rs12070592 rs9434833 1.00 T 0.333 0.02671 2.92 SLC6A17 rs924181 rs1571346 0.64 G 0.583 0.03113 2.59 KCNC4 rs11578913 rs11578913 N/A A 0.167 0.04276 0.33 SLC16A4 rs10857820 rs3768458 0.65 T 0.625 0.04343 2.47 SLC16A4 rs1334882 rs3768458 1.00 T 0.625 0.04343 2.47 CAMK1G rs11119315 rs11119315 N/A A 0.292 0.02755 3.04 CAMK1G rs6690557 rs713075 0.80 A 0.500 0.02324 2.72 KCNH1 rs1770220 rs10863854 0.65 T 0.292 0.04383 0.39 TOLLIP rs3168046 rs2014486 0.85 A 0.667 0.0345 2.62 TOLLIP rs3750920 rs2014486 0.85 A 0.667 0.0345 2.62 OTOG rs2041028 rs734640 0.55 G 0.083 0.03774 0.23 OTOG rs2355466 rs734640 0.55 G 0.083 0.03774 0.23 OTOG rs4757548 rs734640 0.50 G 0.083 0.03774 0.23 OTOG rs7111528 rs734640 0.55 G 0.083 0.03774 0.23 SERGEF rs172424 rs4141243 0.65 C 0.625 0.009037 3.19 SERGEF rs211130 rs4141243 0.65 C 0.625 0.009037 3.19 SERGEF rs211137 rs4141243 0.65 C 0.625 0.009037 3.19 SERGEF rs211146 rs4141243 1.00 C 0.625 0.009037 3.19 SERGEF rs2283233 rs4141243 1.00 C 0.625 0.009037 3.19 SERGEF rs2283233 rs2283233 N/A C 0.583 0.02427 2.71 PTPN5 rs4274187 rs4075664 0.67 C 0.667 0.04808 2.47 HSD17B12 rs1061810 rs10768983 0.87 G 0.455 0.03089 2.72 HSD17B12 rs4755744 rs10768983 1.00 G 0.455 0.03089 2.72 ZFP91-CNTF rs1938596 rs2509920 0.97 C 0.625 0.04343 2.47 ZFP91-CNTF rs4319530 rs2509920 0.90 C 0.625 0.04343 2.47 KIAA1545 rs10870551 rs4418881 1.00 G 0.542 0.01977 2.80 EML1 rs2250718 rs3783322 0.70 G 0.250 0.02801 0.34 UNC13C rs11639005 rs7163424 0.62 T 0.167 0.03824 0.32 UNC13C rs12914912 rs12912762 0.71 A 0.591 0.0436 2.53 UNC13C rs4776216 rs12912762 0.77 A 0.591 0.0436 2.53 UNC13C rs9302181 rs7163424 0.64 T 0.167 0.03824 0.32 AKAP13 rs16977252 rs17623915 0.75 C 0.375 0.005111 3.73 KLHL25 rs2554 rs17623915 0.62 C 0.375 0.005111 3.73 SLCO3A1 rs12912997 rs12912997 N/A G 0.542 0.02862 2.62 IGF1R rs11247380 rs7165181 0.55 G 0.292 0.04586 2.74 IGF1R rs1879613 rs7165181 0.96 G 0.292 0.04586 2.74 CDH8 rs11075445 rs11075445 N/A G 0.208 0.02023 0.31 CDH8 rs1369918 rs11075445 1.00 G 0.208 0.02023 0.31 CDH8 rs1978796 rs11075445 1.00 G 0.208 0.02023 0.31 CDH8 rs6498807 rs11075445 0.80 G 0.208 0.02023 0.31 CDH8 rs9939991 rs4784163 0.55 G 0.167 0.04276 0.33 KIAA0513 rs3794684 rs3794682 0.69 A 0.250 0.03871 0.36 KIAA0513 rs4783121 rs715707 1.00 A 0.125 0.01543 6.24 KIAA0513 rs4783121 rs4783121 N/A A 0.125 0.03696 4.64 COX10 rs2302107 rs1003060 0.89 T 0.042 0.0156 0.12 FUSSEL18 rs10502880 rs17785419 1.00 A 0.292 0.02612 0.35 FUSSEL18 rs17785419 rs17785419 N/A A 0.292 0.02612 0.35 FUSSEL18 rs2668771 rs17785419 0.54 A 0.292 0.02612 0.35 FUSSEL18 rs7236105 rs17785419 0.85 A 0.292 0.02612 0.35 FUSSEL18 rs892583 rs892583 N/A G 0.500 0.001787 3.96 DYM rs8096141 rs16950298 0.61 C 0.167 0.04251 3.63 DCC rs6508145 rs1031062 0.67 G 0.250 0.02271 3.39

Example 6 Novel Markers Associated with Ziprasidone Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on ziprasidone response was performed using as described in Example 2 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Ziprasidone Response and Side Effects:

Tables 10 and 11 report the minor allele frequencies, P values, and ORs for SNPs, in Tables B and C that affect ziprasidone response and side effect rates, respectively. Note in Tables 10 and 11 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 10 and 11.

Tables 10 and 11, provide numerous examples of SNP-based alleles that predict altered response to ziprasidone. For Table 10, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with lesser clinical improvement. For Table 11 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 10 Alleles Affecting Positive Response to Ziprasidone Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r2 Allele responders P OR RP1-21O18.1 rs2073091 rs761288 0.69 C 0.235 0.0481 0.40 RP1-21O18.1 rs4661572 rs761288 0.56 C 0.235 0.0481 0.40 KCND3 rs4838924 rs1373291 0.86 T 0.147 0.03358 0.32 RABGAP1L rs16847624 rs10912854 0.84 C 0.125 0.03253 0.29 RABGAP1L rs6425302 rs10912854 0.96 C 0.125 0.03253 0.29 CACNA1E rs199960 rs3856093 0.51 C 0.206 0.0147 0.31 CACNA1E rs3856090 rs3856093 1.00 C 0.206 0.0147 0.31 CACNA1E rs506947 rs16857457 0.93 G 0.219 0.009356 5.69 DPH3 rs2245721 rs842264 0.57 T 0.618 0.03373 2.49 DPH3 rs842257 rs842264 0.57 T 0.618 0.03373 2.49 DPH3 rs859703 rs842264 0.57 T 0.618 0.03373 2.49 EXOC2 rs2294660 rs2073008 0.54 T 0.000 0.008039 0.00 EXOC2 rs998777 rs2073008 0.74 T 0.000 0.008039 0.00 BRSK2 rs1554857 rs7396009 0.81 T 0.529 0.04022 2.41 HCCA2 rs7396514 rs7396009 1.00 T 0.529 0.04022 2.41 HCCA2 rs7945160 rs7396009 0.55 T 0.529 0.04022 2.41 HCCA2 rs9440 rs7396009 0.55 T 0.529 0.04022 2.41 DUSP8 rs10734456 rs7396009 0.55 T 0.529 0.04022 2.41 DUSP8 rs902224 rs7396009 0.81 T 0.529 0.04022 2.41 KCNQ1 rs231348 rs231348 N/A T 0.294 0.003769 5.08 OTOG rs11024357 rs11024357 N/A C 0.353 0.03601 2.73 OTOG rs11024358 rs11024357 1.00 C 0.353 0.03601 2.73 PTPN5 rs4757707 rs11024786 0.64 T 0.471 0.01003 3.18 NAV2 rs7125647 rs2119981 0.61 A 0.618 0.01558 2.83 SLC6A5 rs2001982 rs7950354 0.57 C 0.147 0.02376 0.30 LRRC4C rs2953310 rs2953310 N/A C 0.235 0.01582 0.33 HSD17B12 rs1061810 rs17596617 0.54 T 0.147 0.02376 0.30 HSD17B12 rs10838160 rs938942 0.59 T 0.618 0.04616 2.36 HSD17B12 rs3802891 rs938942 0.59 T 0.618 0.04616 2.36 HSD17B12 rs4755744 rs17596617 0.65 T 0.147 0.02376 0.30 ZFP91-CNTF rs1938596 rs2509920 0.97 C 0.559 0.04351 2.37 ZFP91-CNTF rs4319530 rs2509920 0.90 C 0.559 0.04351 2.37 DTX4 rs1048444 rs544864 0.55 T 0.147 0.03358 0.32 DTX4 rs2211912 rs2211912 N/A A 0.353 0.03477 0.40 DTX4 rs3847 rs544864 0.55 T 0.147 0.03358 0.32 DTX4 rs5029315 rs2211912 1.00 A 0.353 0.03477 0.40 DTX4 rs544864 rs544864 N/A T 0.147 0.03358 0.32 DTX4 rs621162 rs544864 1.00 T 0.147 0.03358 0.32 DTX4 rs656163 rs2211912 0.88 A 0.353 0.03477 0.40 TTC5 rs10873395 rs8022565 0.77 C 0.441 0.02702 2.68 TTC5 rs2318864 rs8022565 0.73 C 0.441 0.02702 2.68 TTC5 rs3742945 rs8022565 0.73 C 0.441 0.02702 2.68 TTC5 rs2318864 rs2318864 N/A G 0.441 0.04178 2.47 TEP1 rs1713449 rs1760909 0.96 T 0.059 0.01999 0.19 TEP1 rs7150689 rs1760909 0.87 T 0.059 0.01999 0.19 TEP1 rs938886 rs1760909 1.00 T 0.059 0.01999 0.19 TEP1 rs938887 rs1760909 0.67 T 0.059 0.01999 0.19 TEP1 rs1713449 rs1713449 N/A T 0.059 0.02358 0.20 DAAM1 rs1252989 rs1957409 0.94 A 0.250 0.01917 0.33 DAAM1 rs1253005 rs1957409 1.00 A 0.250 0.01917 0.33 DAAM1 rs1268579 rs2053298 1.00 T 0.441 0.04178 2.47 DAAM1 rs4901909 rs1957409 0.62 A 0.250 0.01917 0.33 DAAM1 rs8022614 rs1957409 0.71 A 0.250 0.01917 0.33 DAAM1 rs941884 rs1957409 0.72 A 0.250 0.01917 0.33 EML1 rs11160553 rs8013843 0.71 T 0.059 0.0113 0.17 EML1 rs11160563 rs8020741 0.68 T 0.235 0.02281 0.35 EML1 rs12433613 rs8013843 0.60 T 0.059 0.0113 0.17 EML1 rs6575751 rs8013843 0.71 T 0.059 0.0113 0.17 WDR25 rs10873518 rs11160589 1.00 A 0.529 0.03593 2.48 UNC13C rs12910912 rs12910912 N/A G 0.382 0.001068 5.22 ADAM10 rs4775086 rs7161889 0.55 C 0.382 0.02825 2.79 ADAM10 rs514049 rs7161889 0.70 C 0.382 0.02825 2.79 ADAM10 rs653765 rs7161889 0.79 C 0.382 0.02825 2.79 AKAP13 rs2291049 rs10520596 0.59 G 0.206 0.0113 5.44 AKAP13 rs338556 rs8025135 0.71 G 0.059 0.02358 0.20 KLHL25 rs2430838 rs8025135 0.64 G 0.059 0.02358 0.20 KLHL25 rs2554 rs10520595 0.50 T 0.353 0.02633 2.95 SV2B rs11630131 rs6496778 0.55 G 0.441 0.01303 3.10 SV2B rs2073967 rs6496778 0.87 G 0.441 0.01303 3.10 IGF1R rs11247380 rs4966036 0.55 C 0.265 0.02113 3.60 IGF1R rs1879613 rs4966036 0.96 C 0.265 0.02113 3.60 IGF1R rs8030950 rs1879612 0.66 C 0.559 0.005 3.38 CBLN1 rs11076478 rs1469906 0.72 A 0.206 0.004634 0.26 CBLN1 rs9935379 rs1469906 0.90 A 0.206 0.004634 0.26 CBLN1 rs9935379 rs9935379 N/A G 0.206 0.02119 0.33 CDH8 rs11075445 rs11075445 N/A G 0.559 0.02987 2.53 CDH8 rs1369918 rs11075445 1.00 G 0.559 0.02987 2.53 CDH8 rs1978796 rs11075445 1.00 G 0.559 0.02987 2.53 CDH8 rs6498807 rs1397126 0.51 G 0.281 0.007855 4.62 CDH8 rs9939991 rs6498806 0.65 A 0.294 0.004701 4.92 CDH11 rs35144 rs4967886 0.65 A 0.265 0.007512 0.30 CDH11 rs35148 rs35164 1.00 T 0.177 0.02306 0.32 CDH11 rs35186 rs35216 0.56 G 0.250 0.03882 0.38 KIAA0513 rs12597135 rs8063083 0.53 C 0.559 0.04351 2.37 KIAA0513 rs3751756 rs8063083 0.60 C 0.559 0.04351 2.37 KIAA0182 rs3815794 rs1053328 0.73 T 0.382 0.04528 2.52 FUSSEL18 rs892583 rs11877471 0.68 G 0.441 0.04178 2.47 KIAA0427 rs4939813 rs9959212 0.66 A 0.294 0.03491 0.39 DCC rs1431748 rs7504750 0.63 C 0.412 0.03518 2.60 TMEPAI rs427278 rs203386 0.51 C 0.294 0.01685 0.35

TABLE 11 Alleles Affecting Negative Side Effects for Ziprasidone Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR RERE rs3753275 rs4581300 0.72 T 0.292 0.01404 4.06 SLC6A17 rs1010892 rs17671169 0.70 A 0.708 0.02545 3.02 SLC6A17 rs6689641 rs17671169 0.82 A 0.708 0.02545 3.02 SLC6A17 rs877068 rs17671169 0.60 A 0.708 0.02545 3.02 SLC6A17 rs924181 rs17671169 0.53 A 0.708 0.02545 3.02 DNM3 rs10752946 rs9425598 1.00 A 0.583 0.01857 3.03 CACNA1E rs199960 rs3856093 0.51 C 0.542 0.04571 2.56 CACNA1E rs3856090 rs3856093 1.00 C 0.542 0.04571 2.56 KCNH1 rs11119658 rs1875438 0.59 C 0.292 0.04465 0.37 KCNH1 rs1393026 rs7529770 0.52 G 0.625 0.01287 3.27 KCNH1 rs1501569 rs1501555 0.56 G 0.667 0.01802 3.14 OTOG rs2073582 rs972676 0.71 A 0.250 0.04192 0.35 NAV2 rs1372989 rs1982265 0.54 G 0.000 0.02984 0.00 SLC6A5 rs2001982 rs7950354 0.57 C 0.458 0.0371 2.73 SYT13 rs4992029 rs7117240 0.55 C 0.542 0.03343 2.72 SYT13 rs8929 rs7117240 0.54 C 0.542 0.03343 2.72 CHFR rs2306536 rs4758911 0.94 C 0.458 0.005139 3.97 CHFR rs4758954 rs4758911 0.94 C 0.458 0.005139 3.97 RTN1 rs17255975 rs1884737 0.75 G 0.333 0.04006 2.96 UNC13C rs11639005 rs8025195 0.81 G 0.208 0.04687 0.34 UNC13C rs12594549 rs1864416 0.85 A 0.250 0.004958 6.00 UNC13C rs8025195 rs8025195 N/A G 0.208 0.04687 0.34 UNC13C rs9302181 rs8025195 0.78 G 0.208 0.04687 0.34 AKAP13 rs16977252 rs16949988 0.56 T 0.583 0.01303 3.23 AKAP13 rs338556 rs2241269 0.54 T 0.458 0.0371 2.73 SV2B rs1075840 rs6496780 0.74 G 0.167 0.04248 0.31 SV2B rs11630131 rs17516708 0.66 T 0.000 0.02337 0.00 SV2B rs2073967 rs17516708 0.55 T 0.000 0.02337 0.00 SV2B rs2301665 rs6496780 0.87 G 0.167 0.04248 0.31 NETO2 rs11859615 rs9928466 0.85 C 0.125 0.01646 10.43 NETO2 rs16952126 rs9928466 0.85 C 0.125 0.01646 10.43 NETO2 rs7184206 rs9928466 1.00 C 0.125 0.01646 10.43 NETO2 rs9923731 rs9928466 0.85 C 0.125 0.01646 10.43 CBLN1 rs11076478 rs12598711 0.89 G 0.458 0.004068 4.10 CBLN1 rs9935379 rs12598711 0.72 G 0.458 0.004068 4.10 CDH11 rs35144 rs4967886 0.65 A 0.625 0.04807 2.56 PMP22 rs179521 rs2323653 0.88 A 0.458 0.0371 2.73 FUSSEL18 rs10502880 rs11663646 0.55 T 0.583 0.04765 2.54 FUSSEL18 rs17785419 rs11663646 0.55 T 0.583 0.04765 2.54 DCC rs4940251 rs4940259 0.51 A 0.500 0.03013 2.80 DCC rs6508235 rs4940259 1.00 A 0.500 0.03013 2.80

Example 7 Novel Markers Associated with Overall Response

To assess drug response, the last observation for each patient in treatment Phase 1 of the CATIE trial was used as a primary assessment of efficacy. The standard FDA registration trial definition of response of ≧20% decrease in Positive and Negative Syndrome Scale (PANSS Total Score) was used to assign subjects to a response category. Individuals having composite ordinal effectiveness outcome (COMPEFF) scores of 1 of 2, indicating efficacy, were combined as were those with scores of 3 or 4, indicating lack of efficacy (Davis et al., Schizophr. Bull. 29:73-80 (2003)). The side effects category consisted of individuals discontinued for safety concerns (COMPEFF score 5).

Genetic analysis to document the influence of haplotypes on overall response regardless of the drug used was performed using as described in Example 2 with the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)). PLINK calculates P values for the allele-specific chi-squared test and the odds ratio (OR; or relative risk) associated with the minor allele.

Confirmation of SNP Effects on Overall Response and Side Effects for all Drugs:

Tables 12 and 13 report the minor allele frequencies, P values, and ORs for SNPs, in Tables B and C that affect overall response for all drugs combined and side effect rates for all drugs combined, respectively; for a combined sample set of patients treated with the drugs described in Examples 2 through 6. Note in Tables 12 and 13 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 12 and 13.

Tables 12 and 13, provide numerous examples of SNP-based alleles that predict altered response for all drugs combined (see Examples 2 through 6). For Table 12, ORs of >1.0 indicate that the minor SNP allele is associated with greater clinical improvement, and ORs of <1.0 indicate that the minor SNP allele is associated with lesser clinical improvement. For Table 13 ORs of >1.0 indicate that the minor SNP allele is associated with an increase in study ending side effects, and ORs of <1.0 indicate that the minor SNP allele is associated a decrease in study ending side effects.

TABLE 12 Alleles Affecting Positive Response to For All Drugs Combined Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele responders P OR PRDM2 rs1203682 rs1203682 N/A C 0.159 0.04025 0.67 SLC6A17 rs1010892 rs6689641 0.87 A 0.387 0.02751 0.72 SLC6A17 rs6689641 rs6689641 N/A A 0.387 0.02751 0.72 SLC6A17 rs877068 rs6689641 0.75 A 0.387 0.02751 0.72 KCND3 rs11102342 rs1538388 0.90 A 0.451 0.0118 1.45 DNM3 rs10752946 rs9425598 1.00 A 0.468 0.02928 1.38 DNM3 rs4382763 rs6701929 0.84 C 0.199 0.01233 0.64 KCNH1 rs1770220 rs1777256 1.00 A 0.331 0.03394 0.72 EXOC2 rs2493037 rs2473484 1.00 C 0.171 0.02535 1.58 USH1C rs1055574 rs4756895 0.52 T 0.518 0.02037 1.40 USH1C rs1055577 rs4756895 0.52 T 0.518 0.02037 1.40 USH1C rs16770 rs2237961 0.92 C 0.067 0.01527 0.52 USH1C rs2072225 rs4756895 0.64 T 0.518 0.02037 1.40 USH1C rs4756895 rs4756895 N/A T 0.518 0.02037 1.40 LRRC4C rs2953310 rs2953310 N/A C 0.338 0.02054 0.70 HSD17B12 rs1061810 rs10838184 0.65 C 0.222 0.04552 0.71 HSD17B12 rs10838160 rs7482725 0.62 A 0.514 0.03771 1.36 HSD17B12 rs3802891 rs7482725 0.62 A 0.514 0.03771 1.36 HSD17B12 rs4755744 rs10838184 0.72 C 0.222 0.04552 0.71 KIAA1853 rs6490226 rs7966721 0.53 G 0.436 0.01646 1.43 KIAA1545 rs7294615 rs4242909 0.60 C 0.407 0.03532 0.73 JPH4 rs12897422 rs12897422 N/A A 0.159 0.02094 1.64 DAAM1 rs1252989 rs8004164 0.91 A 0.372 0.02642 0.72 DAAM1 rs1253005 rs8004164 0.97 A 0.372 0.02642 0.72 DAAM1 rs4901909 rs8004164 0.60 A 0.372 0.02642 0.72 DAAM1 rs8022614 rs8004164 0.74 A 0.372 0.02642 0.72 DAAM1 rs941884 rs8004164 0.69 A 0.372 0.02642 0.72 GPR135 rs10136708 rs4898989 0.61 A 0.450 0.02522 1.40 GPR135 rs10138199 rs4898989 1.00 A 0.450 0.02522 1.40 GPR135 rs1253181 rs4898989 0.81 A 0.450 0.02522 1.40 GPR135 rs17255731 rs4898989 0.51 A 0.450 0.02522 1.40 GPR135 rs4898989 rs4898989 N/A A 0.450 0.02522 1.40 GPR135 rs9323348 rs4898989 1.00 A 0.450 0.02522 1.40 RTN1 rs10145080 rs17731838 0.65 T 0.187 0.02742 0.67 RTN1 rs12717467 rs17731838 0.52 T 0.187 0.02742 0.67 RTN1 rs17310036 rs17731838 0.81 T 0.187 0.02742 0.67 EML1 rs10144785 rs17099031 0.63 C 0.197 0.0419 1.48 UNC13C rs12910912 rs12910912 N/A G 0.229 0.004504 1.68 NEDD4 rs2271289 rs12916104 0.86 T 0.458 0.03201 1.37 NEDD4 rs2303579 rs10518831 0.51 G 0.183 0.01556 1.62 NEDD4 rs2303580 rs10518831 0.51 G 0.183 0.01556 1.62 GRINL1A rs4774275 rs1873995 0.51 G 0.416 0.02634 0.72 GRINL1A rs986868 rs9302201 0.90 C 0.405 0.003219 1.56 AKAP13 rs11073502 rs2291048 0.53 A 0.232 0.02934 0.69 AKAP13 rs745191 rs745191 N/A T 0.248 0.04875 0.72 SV2B rs1075840 rs2106692 0.52 A 0.324 0.03372 1.40 SV2B rs1117388 rs2106692 0.61 A 0.324 0.03372 1.40 SV2B rs11630131 rs6496778 0.55 G 0.309 0.002113 1.66 SV2B rs2073967 rs6496778 0.87 G 0.309 0.002113 1.66 SV2B rs2301665 rs2106692 0.56 A 0.324 0.03372 1.40 SV2B rs11630131 rs11630131 N/A A 0.211 0.03028 1.50 RGMA rs13167 rs11074130 0.59 T 0.121 0.02593 1.72 IGF1R rs2684808 rs951715 0.51 G 0.303 0.0154 0.69 CDH11 rs35144 rs4967886 0.65 A 0.335 0.001908 0.62 CDH11 rs35148 rs35140 0.68 G 0.264 0.002194 0.61 CDH11 rs35186 rs35140 0.56 G 0.264 0.002194 0.61 CDH11 rs35195 rs35195 N/A A 0.271 0.003523 0.63 CDH11 rs35144 rs35144 N/A C 0.279 0.006589 0.65 CDH11 rs35186 rs35186 N/A T 0.419 0.02642 0.72 FUSSEL18 rs892583 rs11877471 0.68 G 0.377 0.01138 1.48 FUSSEL18 rs892583 rs892583 N/A G 0.323 0.02405 1.44 SMAD2 rs12457664 rs10502890 1.00 T 0.433 0.04215 0.74 SMAD2 rs1787176 rs10502890 0.82 T 0.433 0.04215 0.74 SMAD2 rs1792666 rs10502890 0.62 T 0.433 0.04215 0.74 SMAD2 rs1792682 rs10502890 0.79 T 0.433 0.04215 0.74 SMAD2 rs2000709 rs10502890 0.94 T 0.433 0.04215 0.74 SMAD2 rs7228393 rs10502890 0.94 T 0.433 0.04215 0.74 SMAD7 rs736839 rs2337153 0.73 A 0.433 0.003271 1.55 SMAD4 rs12458752 rs7243135 0.97 G 0.451 0.04012 1.35 SMAD4 rs12958604 rs7243135 0.97 G 0.451 0.04012 1.35 SMAD4 rs2276163 rs7243135 0.97 G 0.451 0.04012 1.35 SMAD4 rs2298617 rs7243135 0.97 G 0.451 0.04012 1.35 SMAD4 rs3764465 rs7243135 0.97 G 0.451 0.04012 1.35 SMAD4 rs620898 rs7243135 0.97 G 0.451 0.04012 1.35 DCC rs12457407 rs9949949 0.83 A 0.426 0.00489 1.53 DCC rs1393331 rs8088048 0.78 C 0.436 0.02862 1.39 DCC rs1431748 rs7504750 0.63 C 0.329 0.005512 1.57 DCC rs2229080 rs12605899 0.53 C 0.422 0.03279 0.73 DCC rs4940251 rs9949949 0.82 A 0.426 0.00489 1.53 DCC rs6508235 rs9954344 0.62 G 0.418 0.01342 1.45 DCC rs7506904 rs9949949 0.93 A 0.426 0.00489 1.53 DCC rs950278 rs12605899 0.97 C 0.422 0.03279 0.73

TABLE 13 Alleles Increasing Negative Side Effects for All Drugs Combined Table B Test SNP in link- Frequency in Gene Name SNP age disequilibrium r² Allele discontinuers P OR CAMTA1 rs228651 rs11121029 0.51 A 0.154 0.0369 0.61 RERE rs6698830 rs12024032 0.90 C 0.364 0.01972 0.66 RERE rs7530745 rs12024032 0.55 C 0.364 0.01972 0.66 RERE rs7554486 rs12024032 0.80 C 0.364 0.01972 0.66 KCNA10 rs1281174 rs1281177 0.60 A 0.413 0.04816 1.43 KCNA10 rs1281177 rs1281177 N/A A 0.413 0.04816 1.43 CACNA1E rs506947 rs593413 1.00 A 0.082 0.0313 0.52 SYT14 rs4609425 rs12029138 0.96 G 0.414 0.03589 1.46 EXOC2 rs2493049 rs12154040 0.54 C 0.488 0.03739 1.44 NAV2 rs2028570 rs1867116 0.90 T 0.500 0.02091 1.50 NAV2 rs7125647 rs2119981 0.61 A 0.380 0.04636 0.70 SLC17A6 rs11026523 rs2078352 0.79 T 0.138 0.01 0.53 SLC17A6 rs1155821 rs2078352 0.96 T 0.138 0.01 0.53 SLC17A6 rs2078352 rs2078352 N/A T 0.138 0.01 0.53 SLC17A6 rs2246710 rs2078352 1.00 T 0.138 0.01 0.53 DAAM1 rs1252989 rs8004164 0.91 A 0.513 0.01324 1.55 DAAM1 rs1253005 rs8004164 0.97 A 0.513 0.01324 1.55 DAAM1 rs1268579 rs2053298 1.00 T 0.253 0.02417 0.64 DAAM1 rs4127823 rs12589351 0.61 C 0.338 0.02459 0.66 DAAM1 rs4901909 rs8004164 0.60 A 0.513 0.01324 1.55 DAAM1 rs8022614 rs8004164 0.74 A 0.513 0.01324 1.55 DAAM1 rs941884 rs8004164 0.69 A 0.513 0.01324 1.55 GPR135 rs10136708 rs1253170 0.67 T 0.319 0.01197 0.63 GPR135 rs10138199 rs1253170 0.54 T 0.319 0.01197 0.63 GPR135 rs1253181 rs1253170 0.74 T 0.319 0.01197 0.63 GPR135 rs4898989 rs1253170 0.54 T 0.319 0.01197 0.63 GPR135 rs9323348 rs1253170 0.54 T 0.319 0.01197 0.63 EVL rs1190956 rs10136836 0.71 T 0.049 0.02337 0.43 WDR25 rs10873518 rs8005782 1.00 A 0.468 0.007603 1.61 HERC2 rs1635168 rs6497292 0.87 G 0.130 0.01823 1.91 HERC2 rs2238289 rs6497292 0.51 G 0.130 0.01823 1.91 HERC2 rs7495174 rs6497292 0.58 G 0.130 0.01823 1.91 UNC13C rs11856476 rs8024165 0.84 T 0.352 0.01767 1.55 UNC13C rs12914912 rs8024165 0.63 T 0.352 0.01767 1.55 UNC13C rs4776216 rs8024165 0.52 T 0.352 0.01767 1.55 ADAM10 rs3764196 rs7164844 0.51 C 0.074 0.00561 0.42 ADAM10 rs4775086 rs605928 0.59 G 0.222 0.03434 0.65 ADAM10 rs514049 rs605928 0.73 G 0.222 0.03434 0.65 ADAM10 rs653765 rs605928 0.89 G 0.222 0.03434 0.65 CDH11 rs1520233 rs1520233 N/A A 0.309 0.03062 0.67 CDH11 rs35144 rs40115 1.00 T 0.438 0.001518 1.77 CDH11 rs35148 rs40115 0.68 T 0.438 0.001518 1.77 CDH11 rs35186 rs40115 0.56 T 0.438 0.001518 1.77 CDH11 rs35195 rs35195 N/A A 0.438 0.002584 1.71 CDH11 rs35144 rs35144 N/A C 0.430 0.009028 1.60 CDH11 rs35186 rs35186 N/A T 0.544 0.04441 1.43 BEAN rs4247350 rs1063438 0.59 A 0.265 0.01355 0.62 KIAA0182 rs3815794 rs7195186 0.75 G 0.488 0.009922 1.57 KIAA0182 rs736845 rs736845 N/A T 0.231 0.01238 0.60 C16orf74 rs2305357 rs394623 0.55 C 0.321 0.04089 0.69 C16orf74 rs373835 rs394623 0.68 C 0.321 0.04089 0.69 C16orf74 rs386061 rs394623 0.68 C 0.321 0.04089 0.69

Example 8 Novel Markers Associated with Overall Psychiatric Endophenotypes in SZ

Genotype and PANNS phonotype data were evaluated for 417 SZ patients enrolled in the CATIE trial. Following a period of drug wash-out, the CATIE study investigators rated each participant at baseline for psychopathology using the PANSS.

Each of the individual and composite scores is a quantitative trait that can be assessed using quantitative statistical genetics methods. Genetic analysis to determine the influence of haplotypes on quantitative PANSS values was performed using the PLINK 1.03 whole genome analysis toolset developed by Purcell and coworkers (Purcell et al., Am. J. Hum. Genet. 81:559-575 (2007)).

Confirmation of SNP Effects on Psychiatric Endophenotypes:

Tables 14 and 15 show numerous examples of novel alleles that affect the values obtained for specific psychiatric endophenotypes. Note in Tables 14 and 15 that haplotype blocks result in the same Test SNP being in linkage disequilibrium with multiple SNPs in Table B. Similarly, haplotype blocks result in multiple Test SNPs that can be used for each SNP listed in Table B, though such redundant examples are not presented in Tables 12 and 13 unless different test SNPs influence different psychiatric endophenotypes.

Tables 14 and 15 report results for specific SNP alleles that affect quantitative endophenotypes for SZ, along with Beta values and P values for the particular alleles of SNPs listed in Tables B and C. The Beta, beta weight from the regression, measures the impact of the SNP allele on the particular scale. A positive Beta means that the allele for the test SNP increases the score for that measure of psychopathology by the Beta value, while a negative Beta means that the allele for the test SNP decreases the score that for that measure of psychopathology by the Beta value.

Table 14 shows selected examples for PANSS Total score, Positive Symptoms subscale, Negative Symptoms subscale, and the General Psychopathology subscale, analyzed as quantitative traits in PLINK using linear regression.

Table 15 shows selected examples for the individual PANSS components. The component evaluated in each row is identified by one of the following abbreviations: Positive Symptoms: P1-delusions, P2-conceptual disorganization, P3-hallucinatory behavior, P4-excitement, P5-grandiosity, P6-suspiciousness, P7-hostility; Negative Symptoms: N1-blunted affect, N2-emotional withdrawal, N3-poor rapport, N4-passive/apathetic social withdrawal, N5-difficulty in abstract thinking, N6-lack of spontaneity and flow of conversation, N7-stereotyped thinking; General Psychopathology Symptoms: G1-somatic concern, G2-anxiety, G3-guilt feelings, G4-tension, G5-mannerisms and posturing, G6-depression, G7-motor retardation, G8-uncooperativeness, G9-unusual thought content, G10-disorientation, G11-poor attention, G12-lack of judgment and insight, G13 disturbance of volition, G14-poor impulse control, G15-preoccupation, G16-active social avoidance.

TABLE 14 Alleles Influencing Composite Psychiatric Endophenotypes Table B Test SNP in link- Gene Name SNP age disequilibrium r² Allele PANSS Beta P CAMTA1 rs12070592 rs9434833 1.00 T Positive −1.25 0.02983 CAMTA1 rs12070592 rs2071918 1.00 T General −1.83 0.0474 CAMTA1 rs1011124 rs1616122 0.63 C General −1.60 0.01229 CAMTA1 rs1417986 rs2301488 0.54 T Negative 1.05 0.02118 PER3 rs707463 rs228688 0.75 T Negative −1.02 0.0273 PER3 rs707465 rs228688 0.81 T Negative −1.02 0.0273 RP1-21O18.1 rs938249 rs4661563 0.66 G Negative −0.90 0.0453 DNM3 rs4382763 rs12410416 1.00 C Positive 0.97 0.04342 DNM3 rs4382763 rs7550558 0.84 G Total 3.38 0.01491 DNM3 rs4382763 rs2586389 0.84 A Negative 1.24 0.01611 FASLG rs10458360 rs10458360 N/A C General −1.85 0.005609 FASLG rs12135884 rs10458360 0.56 C General −1.85 0.005609 FASLG rs10458360 rs10458360 N/A C Total −2.67 0.03637 FASLG rs12135884 rs10458360 0.56 C Total −2.67 0.03637 CACNA1E rs17494681 rs17494681 N/A T Negative −1.60 0.006522 CACNA1E rs199960 rs1953690 0.81 A General 1.39 0.04994 CACNA1E rs3856090 rs7534913 0.50 A General 1.31 0.04178 CACNA1E rs4652678 rs17693196 0.50 T General 2.21 0.01456 CACNA1E rs704326 rs704331 0.64 G Negative −1.27 0.005535 CAMK1G rs2356933 rs6683256 1.00 T General −1.45 0.03081 CAMK1G rs2356933 rs6683256 1.00 T Total −3.00 0.019 CAMK1G rs17014820 rs10489339 0.70 G Total 3.79 0.0419 KCNH1 rs1770213 rs7546472 0.89 C General 1.91 0.01334 KCNH1 rs1770213 rs7546472 0.89 C Positive 1.31 0.006236 KCNH1 rs1770213 rs7546472 0.89 C Total 3.93 0.007621 KCNH1 rs4620600 rs4951495 0.79 A Negative 1.37 0.01718 KCNH1 rs4620600 rs11119679 0.83 A Positive −1.16 0.0231 EXOC2 rs2493037 rs2473484 1.00 C Positive −1.24 0.03906 ANK3 rs10733757 rs10761446 0.90 C Negative −1.13 0.03077 ANK3 rs4568956 rs10761446 0.57 C Negative −1.13 0.03077 ANK3 rs7907721 rs10761446 0.50 C Negative −1.13 0.03077 RHOG rs1055640 rs1055640 N/A G Positive −0.87 0.03465 RHOG rs11030008 rs11030008 N/A G General 1.44 0.02802 RHOG rs1451722 rs11030008 0.76 G General 1.44 0.02802 RHOG rs11030008 rs11030008 N/A G Positive 1.35 0.000922 RHOG rs1451722 rs11030008 0.76 G Positive 1.35 0.000922 RHOG rs11030008 rs11030008 N/A G Total 3.22 0.01005 RHOG rs1451722 rs11030008 0.76 G Total 3.22 0.01005 USH1C rs1064074 rs1064074 N/A C Negative 0.88 0.04895 USH1C rs2072225 rs1064074 0.54 C Negative 0.88 0.04895 USH1C rs16770 rs2237961 0.92 C Positive 1.61 0.014 OTOG rs10832824 rs7111528 0.75 T Total −2.73 0.04189 OTOG rs2023483 rs7111528 0.70 T Total −2.73 0.04189 OTOG rs2041028 rs7111528 1.00 T Total −2.73 0.04189 OTOG rs7111528 rs7111528 N/A T Total −2.73 0.04189 OTOG rs1003490 rs11024348 0.77 T General −1.65 0.03189 OTOG rs10832824 rs11024348 0.52 T General −1.65 0.03189 OTOG rs2023483 rs11024348 0.50 T General −1.65 0.03189 SERGEF rs4757589 rs11024415 0.63 C General 1.28 0.04742 PTPN5 rs1550870 rs7950091 0.84 T General −1.57 0.01419 PTPN5 rs6483524 rs7950091 0.50 T General −1.57 0.01419 PTPN5 rs10766500 rs11024782 0.93 T General −1.82 0.009458 PTPN5 rs10766500 rs11024782 0.93 T Negative −0.98 0.04673 PTPN5 rs10766500 rs11024782 0.93 T Total −2.97 0.0268 NAV2 rs10833202 rs11025328 0.61 G General −1.66 0.01012 NAV2 rs6483629 rs12099330 0.59 T Positive −1.61 0.01255 SLC6A5 rs1443547 rs16906507 0.54 A General 1.51 0.0386 SLC6A5 rs894750 rs16906507 0.77 A General 1.51 0.0386 SLC6A5 rs1443547 rs16906507 0.54 A Total 2.97 0.03352 SLC6A5 rs894750 rs16906507 0.77 A Total 2.97 0.03352 LRRC4C rs10837367 rs10501227 1.00 G Positive −1.66 0.04454 SYT13 rs2863172 rs4755941 0.80 A General 2.40 0.02256 SYT13 rs2863174 rs4755941 0.88 A General 2.40 0.02256 SYT13 rs4755941 rs4755941 N/A A General 2.40 0.02256 SYT13 rs7103871 rs4755941 0.84 A General 2.40 0.02256 KIAA1853 rs6490226 rs1568922 0.91 C General −1.83 0.01852 KIAA1853 rs6490226 rs1568922 0.91 C Positive −1.07 0.02697 KIAA1853 rs6490226 rs1568922 0.91 C Total −3.74 0.0115 KIAA1853 rs7136574 rs4298970 0.72 A General 1.46 0.03329 KIAA1853 rs7136574 rs4075946 0.82 T Positive −0.91 0.02171 KIAA1853 rs7136574 rs4075946 0.82 T Total −2.54 0.03892 KIAA1853 rs1541764 rs1541764 N/A G General 1.52 0.01871 KIAA1853 rs2555269 rs1541764 0.51 G General 1.52 0.01871 KIAA1853 rs2723880 rs1541764 0.74 G General 1.52 0.01871 KIAA1853 rs2723882 rs1541764 0.55 G General 1.52 0.01871 KIAA1853 rs1541764 rs1541764 N/A G Negative 1.18 0.009674 KIAA1853 rs2555269 rs1541764 0.51 G Negative 1.18 0.009674 KIAA1853 rs2723880 rs1541764 0.74 G Negative 1.18 0.009674 KIAA1853 rs2723882 rs1541764 0.55 G Negative 1.18 0.009674 KIAA1853 rs1541764 rs1541764 N/A G Total 3.21 0.009581 KIAA1853 rs2555269 rs1541764 0.51 G Total 3.21 0.009581 KIAA1853 rs2723880 rs1541764 0.74 G Total 3.21 0.009581 KIAA1853 rs2723882 rs1541764 0.55 G Total 3.21 0.009581 STX2 rs1236 rs7956851 0.81 C Negative −0.99 0.04055 STX2 rs4759517 rs7956851 1.00 C Negative −0.99 0.04055 STX2 rs6486600 rs7956851 0.97 C Negative −0.99 0.04055 STX2 rs6486602 rs7956851 1.00 C Negative −0.99 0.04055 TTC5 rs2318864 rs4981148 0.52 T General −1.69 0.04301 TTC5 rs3737220 rs4981148 0.51 T General −1.69 0.04301 TTC5 rs3742945 rs4981148 0.52 T General −1.69 0.04301 TTC5 rs2318864 rs4981148 0.52 T Total −3.18 0.04708 TTC5 rs3737220 rs4981148 0.51 T Total −3.18 0.04708 TTC5 rs3742945 rs4981148 0.52 T Total −3.18 0.04708 TEP1 rs1713449 rs1713448 0.96 A General 1.55 0.0488 TEP1 rs7150689 rs1713448 0.87 A General 1.55 0.0488 TEP1 rs938886 rs1713448 1.00 A General 1.55 0.0488 TEP1 rs938887 rs1713448 0.67 A General 1.55 0.0488 JPH4 rs12897422 rs12897422 N/A A General −2.40 0.0136 JPH4 rs12897422 rs12897422 N/A A Negative −2.00 0.003322 JPH4 rs12897422 rs12897422 N/A A Total −5.10 0.00594 DAAM1 rs10143918 rs10483710 0.58 A Negative −1.48 0.01586 DAAM1 rs12147707 rs10483710 0.86 A Negative −1.48 0.01586 DAAM1 rs17095965 rs10483710 0.86 A Negative −1.48 0.01586 DAAM1 rs1252989 rs4901909 0.62 T Positive 0.83 0.04088 DAAM1 rs1253005 rs4901909 0.62 T Positive 0.83 0.04088 DAAM1 rs4901909 rs4901909 N/A T Positive 0.83 0.04088 DAAM1 rs8022614 rs4901909 0.60 T Positive 0.83 0.04088 DAAM1 rs941884 rs4901909 0.85 T Positive 0.83 0.04088 DAAM1 rs10143918 rs6573250 0.69 T General −1.52 0.01672 DAAM1 rs11626926 rs1547199 0.85 T General 1.37 0.03582 DAAM1 rs4127823 rs1271513 0.65 C General −1.57 0.02025 DAAM1 rs941886 rs1271513 1.00 C General −1.57 0.02025 EML1 rs2250718 rs3783322 0.70 G General 1.54 0.01544 EML1 rs2250718 rs3783322 0.70 G Negative 1.10 0.01418 EML1 rs2250718 rs3783322 0.70 G Total 2.62 0.03153 EML1 rs11160553 rs11160554 1.00 C Negative −1.83 0.000141 EML1 rs11160563 rs11160554 0.56 C Negative −1.83 0.000141 EML1 rs12433613 rs11160554 0.88 C Negative −1.83 0.000141 EML1 rs6575751 rs11160554 1.00 C Negative −1.83 0.000141 EML1 rs746698 rs10131519 0.91 C Positive 1.07 0.03808 EML1 rs746698 rs10131519 0.91 C Total 3.17 0.04577 EML1 rs2273707 rs2250718 0.53 T General 1.29 0.04771 EML1 rs2273704 rs3818279 0.58 G Negative 1.53 0.004398 EML1 rs746698 rs3818279 0.71 G Negative 1.53 0.004398 EML1 rs11160553 rs4900447 0.59 A General −2.06 0.002015 EML1 rs11160563 rs4900447 0.97 A General −2.06 0.002015 EML1 rs12433613 rs4900447 0.51 A General −2.06 0.002015 EML1 rs6575751 rs4900447 0.59 A General −2.06 0.002015 EML1 rs11160553 rs4900447 0.59 A Total −4.44 0.000493 EML1 rs11160563 rs4900447 0.97 A Total −4.44 0.000493 EML1 rs12433613 rs4900447 0.51 A Total −4.44 0.000493 EML1 rs6575751 rs4900447 0.59 A Total −4.44 0.000493 HERC2 rs11631797 rs916977 0.86 T Negative 1.26 0.01939 HERC2 rs2238289 rs916977 0.79 T Negative 1.26 0.01939 HERC2 rs916977 rs916977 N/A T Negative 1.26 0.01939 UNC13C rs17731958 rs17731958 N/A T General −3.74 0.01791 UNC13C rs2163195 rs8024845 1.00 G Negative 0.97 0.04595 UNC13C rs489526 rs573320 0.70 A Negative −1.04 0.04416 UNC13C rs489526 rs500853 1.00 G Total −2.76 0.03901 UNC13C rs16974691 rs16974712 0.96 T General −1.57 0.04754 UNC13C rs16974691 rs16974712 0.96 T Negative −1.39 0.01224 UNC13C rs16974691 rs16974712 0.96 T Total −3.83 0.01099 Gcom1 rs4774275 rs9806498 1.00 T Positive 0.98 0.01975 GCOM1 rs16977629 rs16977629 N/A T Negative 2.21 0.01041 Gcom1 rs16977631 rs16977629 0.56 T Negative 2.21 0.01041 GRINL1A rs986868 rs7176042 0.75 A Positive −0.99 0.01843 AKAP13 rs745191 rs745191 N/A T Positive 0.99 0.02393 AKAP13 rs11073502 rs2291048 0.53 A Positive 1.22 0.006071 AKAP13 rs2241268 rs2241268 N/A A Positive 1.04 0.01761 KLHL25 rs11637212 rs11637212 N/A G Positive 1.07 0.01597 SV2B rs11630131 rs11631712 0.55 C Negative −1.50 0.002999 SV2B rs2073967 rs11631712 0.87 C Negative −1.50 0.002999 SLCO3A1 rs2286355 rs11630872 0.85 T Negative −0.99 0.04033 IGF1R rs7170035 rs4966012 0.55 C Negative −1.04 0.03039 IGF1R rs4965436 rs11634874 0.76 C Positive 1.43 0.02266 IGF1R rs2684792 rs7173377 0.96 C Positive 1.22 0.0019 CBLN1 rs11076478 rs1469906 0.72 A Negative −1.15 0.01235 CBLN1 rs9935379 rs1469906 0.90 A Negative −1.15 0.01235 ZNF423 rs12924119 rs4785185 0.50 T Positive −1.04 0.03187 CDH8 rs4131634 rs11862752 0.51 A General −2.74 0.006021 CDH8 rs4131634 rs11862752 0.51 A Total −4.07 0.03321 CDH8 rs9939991 rs13336134 0.55 C Positive −0.99 0.01792 CDH8 rs11075445 rs7189354 1.00 G Positive −1.23 0.002488 CDH8 rs1369918 rs7189354 1.00 G Positive −1.23 0.002488 CDH8 rs1978796 rs7189354 1.00 G Positive −1.23 0.002488 CDH8 rs6498807 rs7189354 0.80 G Positive −1.23 0.002488 CDH8 rs1397131 rs16964164 0.90 T Negative 0.91 0.04219 CDH8 rs8057338 rs16964164 0.93 T Negative 0.91 0.04219 CDH8 rs9302540 rs16964164 0.93 T Negative 0.91 0.04219 CDH11 rs1520233 rs4625747 0.67 T General −1.51 0.02769 CDH11 rs35148 rs35162 1.00 A General 1.73 0.01682 CDH11 rs35144 rs35162 0.68 A Positive 1.14 0.01107 CDH11 rs35148 rs35162 1.00 A Positive 1.14 0.01107 CDH11 rs35144 rs35162 0.68 A Total 3.04 0.02738 CDH11 rs35148 rs35162 1.00 A Total 3.04 0.02738 CDH11 rs35186 rs35140 0.56 G Positive 0.91 0.0272 CDH11 rs35195 rs35195 N/A A General 1.45 0.02761 CDH11 rs35195 rs35195 N/A A Positive 0.87 0.03339 CDH11 rs35144 rs35186 0.56 T General 1.58 0.0137 CDH11 rs35186 rs35186 N/A T General 1.58 0.0137 CDH11 rs35186 rs35186 N/A T Total 2.57 0.03558 KIAA0182 rs1049868 rs732460 0.58 T Negative 1.11 0.03822 KIAA0182 rs3815795 rs732460 0.59 T Negative 1.11 0.03822 PMP22 rs13422 rs192046 0.93 T General 1.28 0.03702 PMP22 rs230938 rs192046 0.67 T General 1.28 0.03702 PMP22 rs179521 rs11656487 0.83 C General −1.41 0.02417 PMP22 rs231018 rs11656487 0.52 C General −1.41 0.02417 PMP22 rs179521 rs11656487 0.83 C Total −2.48 0.03766 PMP22 rs231018 rs11656487 0.52 C Total −2.48 0.03766 KATNAL2 rs2187092 rs2010834 0.97 A General 2.27 0.0008 KATNAL2 rs2247221 rs2010834 0.56 A General 2.27 0.0008 KATNAL2 rs2571030 rs2010834 0.56 A General 2.27 0.0008 KATNAL2 rs2576042 rs2010834 0.59 A General 2.27 0.0008 KATNAL2 rs7233515 rs2010834 0.69 A General 2.27 0.0008 KATNAL2 rs9304340 rs2010834 0.97 A General 2.27 0.0008 KATNAL2 rs2187092 rs2010834 0.97 A Negative 1.18 0.01344 KATNAL2 rs2247221 rs2010834 0.56 A Negative 1.18 0.01344 KATNAL2 rs2571030 rs2010834 0.56 A Negative 1.18 0.01344 KATNAL2 rs2576042 rs2010834 0.59 A Negative 1.18 0.01344 KATNAL2 rs7233515 rs2010834 0.69 A Negative 1.18 0.01344 KATNAL2 rs9304340 rs2010834 0.97 A Negative 1.18 0.01344 KATNAL2 rs2187092 rs2010834 0.97 A Total 4.45 0.000588 KATNAL2 rs2247221 rs2010834 0.56 A Total 4.45 0.000588 KATNAL2 rs2571030 rs2010834 0.56 A Total 4.45 0.000588 KATNAL2 rs2576042 rs2010834 0.59 A Total 4.45 0.000588 KATNAL2 rs7233515 rs2010834 0.69 A Total 4.45 0.000588 KATNAL2 rs9304340 rs2010834 0.97 A Total 4.45 0.000588 KATNAL2 rs9961383 rs2571034 0.60 G General 1.61 0.01919 KATNAL2 rs9961383 rs2571034 0.60 G Total 2.68 0.04215 KATNAL2 rs2187092 rs2576040 0.57 T Positive −1.02 0.01334 KATNAL2 rs2247221 rs2576040 0.61 T Positive −1.02 0.01334 KATNAL2 rs2571030 rs2576040 0.61 T Positive −1.02 0.01334 KATNAL2 rs2576042 rs2576040 1.00 T Positive −1.02 0.01334 KATNAL2 rs7233515 rs2576040 0.51 T Positive −1.02 0.01334 KATNAL2 rs9304340 rs2576040 0.57 T Positive −1.02 0.01334 FUSSEL18 rs10502880 rs9304344 0.85 T General −1.48 0.02048 FUSSEL18 rs17785419 rs9304344 0.85 T General −1.48 0.02048 FUSSEL18 rs2668771 rs9304344 0.64 T General −1.48 0.02048 FUSSEL18 rs7236105 rs9304344 1.00 T General −1.48 0.02048 FUSSEL18 rs10502880 rs9304344 0.85 T Positive −0.87 0.02914 FUSSEL18 rs17785419 rs9304344 0.85 T Positive −0.87 0.02914 FUSSEL18 rs2668771 rs9304344 0.64 T Positive −0.87 0.02914 FUSSEL18 rs7236105 rs9304344 1.00 T Positive −0.87 0.02914 FUSSEL18 rs10502880 rs9304344 0.85 T Total −2.69 0.02795 FUSSEL18 rs17785419 rs9304344 0.85 T Total −2.69 0.02795 FUSSEL18 rs2668771 rs9304344 0.64 T Total −2.69 0.02795 FUSSEL18 rs7236105 rs9304344 1.00 T Total −2.69 0.02795 DCC rs6508145 rs1031062 0.67 G Negative −1.36 0.02919 DCC rs6508145 rs1031062 0.67 G Total −3.34 0.04901 DCC rs1893572 rs7228674 0.77 T Negative 1.68 0.000333 DCC rs1893572 rs9807201 0.65 A General 1.73 0.01191 DCC rs1893572 rs9807201 0.65 A Total 3.16 0.01642 DCC rs1431748 rs4998815 0.61 G General −1.47 0.02576 DCC rs1431748 rs9953016 0.81 C Negative −1.13 0.0172 DCC rs1431748 rs7504750 0.63 C Total −2.97 0.02854 TMEPAI rs427278 rs203386 0.51 C General 1.51 0.02214 TMEPAI rs427278 rs203386 0.51 C Total 2.78 0.02738

TABLE 15 Alleles Influencing Specific Psychiatric Endophenotypes Table B Test SNP in link- Gene Name SNP age disequilibrium r² Allele PANSS Beta P CAMTA1 rs7554752 rs4908575 0.96 C G10 0.18 0.002944 CAMTA1 rs12070592 rs2071918 1.00 T G6 −0.42 0.002692 CAMTA1 rs12070592 rs2071918 1.00 T G9 −0.38 0.003607 CAMTA1 rs707455 rs697686 0.66 T N7 −0.27 0.002057 PER3 rs707463 rs707463 N/A T N7 −0.25 0.004339 PER3 rs707465 rs697686 0.93 T N7 −0.27 0.002057 PER3 rs707463 rs697686 1.00 T N7 −0.27 0.002057 PER3 rs2640909 rs228652 0.70 A N5 −0.34 0.002229 RP1-21O18.1 rs12057431 rs10803343 1.00 C G14 0.95 0.0002941 RP1-21O18.1 rs4661572 rs1000313 0.63 G G14 0.28 0.0003008 KCND3 rs3738298 rs584096 0.70 G G10 −0.28 0.0003434 DNM3 rs4382763 rs2586392 0.84 C N7 0.27 0.003464 CACNA1E rs17494681 rs17494681 N/A T N4 −0.37 0.003546 CACNA1E rs3856090 rs10797729 0.70 A G7 0.34 0.0001445 CACNA1E rs199960 rs10797729 0.77 A G7 0.34 0.0001445 CACNA1E rs199960 rs7513540 0.61 T G1 −0.32 0.001712 CACNA1E rs4652678 rs17693196 0.50 T G1 0.40 0.002089 CACNA1E rs704326 rs704331 0.64 G G7 −0.28 0.0005166 CACNA1E rs704326 rs704331 0.64 G N1 −0.32 0.00162 CACNA1E rs704326 rs704331 0.64 G N3 −0.28 0.001365 CACNA1E rs704326 rs704331 0.64 G N6 −0.32 0.0008968 CAMK1G rs17014820 rs7512091 0.91 A G5 0.29 0.001812 CAMK1G rs6690557 rs713075 0.80 A G5 −0.23 0.003493 CAMK1G rs17014820 rs7516885 1.00 T N7 0.38 0.0007187 CAMK1G rs17014820 rs10489339 0.70 G G4 0.43 0.0006328 KCNH1 rs1770213 rs7546472 0.89 C P1 0.39 0.003181 DPH3 rs2245721 rs842264 0.57 T P5 0.30 0.0005309 DPH3 rs842257 rs842264 0.57 T P5 0.30 0.0005309 DPH3 rs859703 rs842264 0.57 T P5 0.30 0.0005309 DPH3 rs2245708 rs842261 0.67 A P5 0.27 0.004185 DPH3 rs2245721 rs842251 1.00 G G10 0.20 0.000734 DPH3 rs842257 rs842251 1.00 G G10 0.20 0.000734 DPH3 rs859703 rs842251 1.00 G G10 0.20 0.000734 DPH3 rs2245721 rs842259 1.00 T G7 −0.23 0.004115 DPH3 rs842257 rs842259 1.00 T G7 −0.23 0.004115 DPH3 rs859703 rs842259 1.00 T G7 −0.23 0.004115 EXOC2 rs1473909 rs9405242 0.97 A N5 −0.35 0.0008412 TOLLIP rs3168046 rs2014486 0.85 A G7 −0.24 0.001849 TOLLIP rs3750920 rs2014486 0.85 A G7 −0.24 0.001849 BRSK2 rs1554857 rs1554857 N/A A G5 −0.23 0.002684 BRSK2 rs1554857 rs1108991 0.81 G G5 −0.25 0.001173 HCCA2 rs7945160 rs1108991 0.55 G G5 −0.25 0.001173 HCCA2 rs9440 rs1108991 0.55 G G5 −0.25 0.001173 HCCA2 rs7396514 rs1108991 1.00 G G5 −0.25 0.001173 DUSP8 rs10734456 rs1108991 0.55 G G5 −0.25 0.001173 DUSP8 rs902224 rs1108991 0.81 G G5 −0.25 0.001173 RHOG rs1055640 rs1055640 N/A G G4 −0.25 0.003073 RHOG rs1451722 rs11030008 0.76 G P1 0.32 0.00439 RHOG rs11030008 rs11030008 N/A G P1 0.32 0.00439 RHOG rs1451722 rs11030008 0.76 G P6 0.33 0.001515 RHOG rs11030008 rs11030008 N/A G P6 0.33 0.001515 USH1C rs2072225 rs1064074 0.54 C G16 0.28 0.002619 USH1C rs1064074 rs1064074 N/A C G16 0.28 0.002619 USH1C rs16770 rs2237961 0.92 C P4 0.42 0.0007385 OTOG rs2041028 rs757982 0.64 A G12 −0.32 0.0007194 OTOG rs7111528 rs757982 0.64 A G12 −0.32 0.0007194 OTOG rs2023483 rs7111528 0.70 T P2 −0.27 0.008232 OTOG rs10832824 rs7111528 0.75 T P2 −0.27 0.008232 OTOG rs2041028 rs7111528 1.00 T P2 −0.27 0.008232 OTOG rs7111528 rs7111528 N/A T P2 −0.27 0.008232 OTOG rs2023483 rs4757560 0.52 C P5 −0.25 0.008921 PTPN5 rs10766500 rs11024782 0.93 T G16 −0.31 0.002084 PTPN5 rs10766500 rs755796 0.93 G G10 −0.19 0.004029 NAV2 rs10833202 rs11025328 0.61 G G15 −0.25 0.003892 NAV2 rs7125647 rs10833228 0.65 C G11 0.30 0.0007124 LRRC4C rs2953310 rs2953310 N/A C P4 −0.21 0.004729 LRRC4C rs10837367 rs10501227 1.00 G P1 −0.67 0.003309 HSD17B12 rs1061810 rs10838186 0.87 C G5 0.21 0.003535 HSD17B12 rs4755744 rs10838186 1.00 C G5 0.21 0.003535 HSD17B12 rs11037691 rs11037691 N/A A G5 0.39 0.004419 SYT13 rs12362429 rs12362444 1.00 G G10 0.21 0.0007107 SYT13 rs12362429 rs12362444 1.00 G P2 0.29 0.002839 SYT13 rs4992029 rs1075778 0.61 G P2 0.27 0.009285 SYT13 rs2863182 rs1075778 0.84 G P2 0.27 0.009285 SYT13 rs11038382 rs1075778 1.00 G P2 0.27 0.009285 SYT13 rs4992029 rs6485608 0.50 C G10 0.20 0.002462 SYT13 rs11038382 rs6485608 0.84 C G10 0.20 0.002462 SYT13 rs2863182 rs6485608 1.00 C G10 0.20 0.002462 DTX4 rs1048444 rs2211912 0.77 A N6 0.32 0.0006063 DTX4 rs3847 rs2211912 0.77 A N6 0.32 0.0006063 DTX4 rs656163 rs2211912 0.88 A N6 0.32 0.0006063 DTX4 rs5029315 rs2211912 1.00 A N6 0.32 0.0006063 DTX4 rs2211912 rs2211912 N/A A N6 0.32 0.0006063 DTX4 rs3847 rs3847 N/A A N6 0.30 0.003075 DTX4 rs621162 rs544864 1.00 T N6 0.35 0.0008417 DTX4 rs544864 rs544864 N/A T N6 0.35 0.0008417 KIAA1853 rs6490226 rs7966721 0.53 G N1 −0.32 0.00181 KIAA1853 rs7136574 rs4298970 0.72 A G1 0.28 0.004999 RIMBP2 rs4237817 rs1877978 0.55 C G4 0.25 0.003266 TTC5 rs3737220 rs4981148 0.51 T G15 −0.32 0.004087 TTC5 rs2318864 rs4981148 0.52 T G15 −0.32 0.004087 TTC5 rs3742945 rs4981148 0.52 T G15 −0.32 0.004087 NDRG2 rs1243444 rs1243446 0.58 G G15 0.23 0.004573 NDRG2 rs1243446 rs1243446 N/A G G15 0.23 0.004573 JPH4 rs12897422 rs12897422 N/A A G2 −0.45 0.0009928 JPH4 rs12897422 rs12897422 N/A A G6 −0.44 0.002891 JPH4 rs12897422 rs12897422 N/A A N4 −0.43 0.003217 DACT1 rs464582 rs464582 N/A C G14 −0.19 0.0041 DACT1 rs464582 rs464582 N/A C P4 −0.22 0.004041 DACT1 rs464582 rs464582 N/A C P7 −0.21 0.001554 DAAM1 rs12147707 rs10483710 0.86 A G13 −0.36 0.0009634 DAAM1 rs17095965 rs10483710 0.86 A G13 −0.36 0.0009634 DAAM1 rs10143918 rs10483710 0.58 A G5 −0.28 0.003772 DAAM1 rs12147707 rs10483710 0.86 A G5 −0.28 0.003772 DAAM1 rs17095965 rs10483710 0.86 A G5 −0.28 0.003772 DAAM1 rs10143918 rs6573250 0.69 T G13 −0.28 0.0003461 DAAM1 rs941886 rs941886 N/A C G13 −0.24 0.003883 DAAM1 rs11626926 rs1547199 0.85 T G13 0.23 0.004418 DAAM1 rs4127823 rs1271513 0.65 C G13 −0.25 0.003443 DAAM1 rs941886 rs1271513 1.00 C G13 −0.25 0.003443 GPR135 rs17255731 rs4898989 0.51 A P6 −0.29 0.005506 GPR135 rs10136708 rs4898989 0.61 A P6 −0.29 0.005506 GPR135 rs1253181 rs4898989 0.81 A P6 −0.29 0.005506 GPR135 rs10138199 rs4898989 1.00 A P6 −0.29 0.005506 GPR135 rs9323348 rs4898989 1.00 A P6 −0.29 0.005506 GPR135 rs4898989 rs4898989 N/A A P6 −0.29 0.005506 GPR135 rs10136708 rs1253103 0.54 C G16 −0.27 0.003698 GPR135 rs17255731 rs1253103 0.57 C G16 −0.27 0.003698 GPR135 rs1253181 rs1253103 0.71 C G16 −0.27 0.003698 GPR135 rs10138199 rs1253103 0.88 C G16 −0.27 0.003698 GPR135 rs4898989 rs1253103 0.88 C G16 −0.27 0.003698 GPR135 rs9323348 rs1253103 0.88 C G16 −0.27 0.003698 RTN1 rs10145080 rs12878097 0.55 C G12 0.32 0.003522 RTN1 rs17310036 rs12878097 1.00 C G12 0.32 0.003522 RTN1 rs17310036 rs1951366 0.79 A N3 0.26 0.002511 RTN1 rs10145080 rs17256003 0.55 C G8 0.20 0.0032 RTN1 rs17310036 rs17256003 1.00 C G8 0.20 0.0032 EML1 rs2250718 rs3783322 0.70 G G7 0.29 0.0002896 EML1 rs11160563 rs11160554 0.56 C N1 −0.35 0.001551 EML1 rs11160563 rs11160554 0.56 C N6 −0.30 0.003367 EML1 rs12433613 rs11160554 0.88 C N6 −0.30 0.003367 EML1 rs11160553 rs11160554 1.00 C N6 −0.30 0.003367 EML1 rs6575751 rs11160554 1.00 C N6 −0.30 0.003367 EML1 rs11160563 rs1957509 0.56 A G7 −0.29 0.0006263 EML1 rs12433613 rs1957509 0.88 A G7 −0.29 0.0006263 EML1 rs11160553 rs1957509 1.00 A G7 −0.29 0.0006263 EML1 rs6575751 rs1957509 1.00 A G7 −0.29 0.0006263 EML1 rs11160553 rs1191109 0.51 A N1 −0.37 0.0002563 EML1 rs6575751 rs1191109 0.51 A N1 −0.37 0.0002563 EML1 rs11160553 rs1191109 0.51 A N3 −0.28 0.001132 EML1 rs6575751 rs1191109 0.51 A N3 −0.28 0.001132 EML1 rs12433613 rs1005766 0.77 G N1 −0.35 0.001409 EML1 rs12433613 rs1005766 0.77 G N4 −0.30 0.003513 EML1 rs11160553 rs1005766 0.88 G N4 −0.30 0.003513 EML1 rs6575751 rs1005766 0.88 G N4 −0.30 0.003513 EML1 rs2273707 rs975252 0.59 T G7 0.26 0.001636 EML1 rs2273707 rs2250718 0.53 T G2 0.31 0.0005703 EML1 rs2250718 rs2250718 N/A T G2 0.31 0.0005703 EML1 rs2273704 rs3818279 0.58 G N1 0.41 0.0006622 EML1 rs746698 rs3818279 0.71 G N1 0.41 0.0006622 EML1 rs11160563 rs8020741 0.68 T G5 −0.22 0.00144 EML1 rs12433613 rs4900447 0.51 A G15 −0.31 0.0004618 EML1 rs11160553 rs4900447 0.59 A G15 −0.31 0.0004618 EML1 rs6575751 rs4900447 0.59 A G15 −0.31 0.0004618 EML1 rs11160563 rs4900447 0.97 A G15 −0.31 0.0004618 EML1 rs12433613 rs4900447 0.51 A G5 −0.22 0.002755 EML1 rs11160553 rs4900447 0.59 A G5 −0.22 0.002755 EML1 rs6575751 rs4900447 0.59 A G5 −0.22 0.002755 EML1 rs12433613 rs4900447 0.51 A N7 −0.25 0.003313 EML1 rs11160553 rs4900447 0.59 A N7 −0.25 0.003313 EML1 rs6575751 rs4900447 0.59 A N7 −0.25 0.003313 EML1 rs11160563 rs4900447 0.97 A N7 −0.25 0.003313 EVL rs1190956 rs2400848 0.51 C G16 −0.54 0.004824 BEGAIN rs7140556 rs1190862 0.65 T G14 −0.23 0.001153 HERC2 rs2238289 rs916977 0.79 T N3 0.37 0.0003766 HERC2 rs11631797 rs916977 0.86 T N3 0.37 0.0003766 HERC2 rs916977 rs916977 N/A T N3 0.37 0.0003766 HERC2 rs2238289 rs916977 0.79 T N6 0.37 0.001355 HERC2 rs11631797 rs916977 0.86 T N6 0.37 0.001355 HERC2 rs916977 rs916977 N/A T N6 0.37 0.001355 UNC13C rs17731958 rs17731958 N/A T G6 −0.95 0.00007556 UNC13C rs489526 rs500853 1.00 G N7 −0.25 0.004691 UNC13C rs489526 rs500853 1.00 G P2 −0.29 0.004176 UNC13C rs16974691 rs16974712 0.96 T G10 −0.21 0.0047 UNC13C rs16974691 rs16974712 0.96 T P2 −0.34 0.003461 Gcom1 rs16977631 rs16977629 0.56 T G16 0.52 0.003424 Gcom1 rs16977629 rs16977629 N/A T G16 0.52 0.003424 GRINL1A rs986868 rs1425948 0.97 A P7 −0.21 0.001524 AKAP13 rs745191 rs745191 N/A T G9 0.29 0.003429 AKAP13 rs11073502 rs2291048 0.53 A G9 0.30 0.002606 AKAP13 rs11073502 rs2291048 0.53 A P1 0.37 0.002475 AKAP13 rs2241268 rs2241268 N/A A G9 0.28 0.004651 KLHL25 rs11637212 rs11637212 N/A G P5 0.26 0.009632 SV2B rs11630131 rs11631712 0.55 C N4 −0.31 0.003964 SV2B rs2073967 rs11631712 0.87 C N4 −0.31 0.003964 SLCO3A1 rs4294800 rs8032981 0.67 A G1 −0.35 0.001287 SLCO3A1 rs4294800 rs975721 0.51 G P5 −0.26 0.004699 SLCO3A1 rs2176452 rs975721 0.53 G P5 −0.26 0.004699 IGF1R rs4965436 rs11634874 0.76 C P5 0.40 0.005139 IGF1R rs11247380 rs1879613 0.53 A G1 0.39 0.0005785 IGF1R rs1879613 rs1879613 N/A A G1 0.39 0.0005785 IGF1R rs2684792 rs7173377 0.96 C G9 0.26 0.004224 IGF1R rs2684792 rs7173377 0.96 C P3 0.33 0.003003 IGF1R rs2684792 rs7173377 0.96 C P5 0.27 0.002108 NDRG4 rs42945 rs40359 0.66 C G12 −0.28 0.002966 GOT2 rs2042445 rs7204324 0.51 T P5 −0.41 0.008799 CDH8 rs4636897 rs11641508 1.00 A G2 0.44 0.0009623 CDH8 rs4131634 rs4416006 0.96 C G5 −0.25 0.002379 CDH8 rs4131634 rs11862752 0.51 A G4 −0.39 0.002652 CDH8 rs6498807 rs7189354 0.80 G P1 −0.32 0.004743 CDH8 rs11075445 rs7189354 1.00 G P1 −0.32 0.004743 CDH8 rs1369918 rs7189354 1.00 G P1 −0.32 0.004743 CDH8 rs1978796 rs7189354 1.00 G P1 −0.32 0.004743 CDH11 rs35144 rs35165 0.68 A G6 0.35 0.001477 CDH11 rs35148 rs35165 1.00 A G6 0.35 0.001477 CDH11 rs35144 rs35162 0.68 A G2 0.29 0.00496 CDH11 rs35148 rs35162 1.00 A G2 0.29 0.00496 KIAA0513 rs4783121 rs16975240 0.87 G G6 −0.70 0.002637 PMP22 rs13422 rs231020 0.64 T P3 −0.36 0.0008073 PMP22 rs231021 rs231020 0.67 T P3 −0.36 0.0008073 PMP22 rs231018 rs231020 0.93 T P3 −0.36 0.0008073 PMP22 rs231018 rs10852830 0.52 C G13 −0.24 0.001942 PMP22 rs179521 rs10852830 0.83 C G13 −0.24 0.001942 KATNAL2 rs2247221 rs2010834 0.56 A N7 0.33 0.0001519 KATNAL2 rs2571030 rs2010834 0.56 A N7 0.33 0.0001519 KATNAL2 rs2576042 rs2010834 0.59 A N7 0.33 0.0001519 KATNAL2 rs7233515 rs2010834 0.69 A N7 0.33 0.0001519 KATNAL2 rs2187092 rs2010834 0.97 A N7 0.33 0.0001519 KATNAL2 rs9304340 rs2010834 0.97 A N7 0.33 0.0001519 KIAA0427 rs2175565 rs9952398 1.00 C G1 −0.31 0.00361 KIAA0427 rs937021 rs937021 N/A G N5 0.30 0.003682 DYM rs357894 rs357894 N/A C G9 −0.33 0.0006157 DYM rs498929 rs16950465 0.54 T G9 −0.36 0.001734 DCC rs17753970 rs16954731 0.87 G G4 0.27 0.004839 DCC rs8089980 rs8089980 N/A T G16 0.27 0.003432 DCC rs8089980 rs8089980 N/A T G7 0.24 0.002252 DCC rs8089980 rs10853621 0.76 T G7 0.25 0.001494 DCC rs8089980 rs10853622 0.76 A G12 −0.27 0.004596 DCC rs1893572 rs7228674 0.77 T G16 0.28 0.004286 DCC rs1893572 rs7228674 0.77 T N1 0.32 0.002084 DCC rs1893572 rs7228674 0.77 T N2 0.26 0.004955 DCC rs1893572 rs7228674 0.77 T N6 0.28 0.004787 DCC rs1893572 rs9807201 0.65 A G7 0.32 0.000156 DCC rs1893572 rs9807201 0.65 A N3 0.30 0.001024 DCC rs1431748 rs4998815 0.61 G G12 −0.28 0.004202 DCC rs950278 rs12967277 0.60 G G12 0.28 0.002738 DCC rs950278 rs12455180 0.53 T P2 −0.25 0.008191 DCC rs2229080 rs12455180 0.64 T P2 −0.25 0.008191 DCC rs1431748 rs9953016 0.81 C N2 −0.29 0.001508 DCC rs1431748 rs7504750 0.63 C G2 −0.32 0.001379 DCC rs8096519 rs11082964 0.95 G N2 0.30 0.004634 DCC rs12457407 rs9954344 0.61 G P2 −0.27 0.004541 DCC rs6508235 rs9954344 0.62 G P2 −0.27 0.004541 DCC rs7506904 rs9954344 0.69 G P2 −0.27 0.004541 DCC rs4940251 rs9954344 0.86 G P2 −0.27 0.004541 DCC rs2270954 rs2270954 N/A A P6 −0.46 0.002603 BMP7 rs10375 rs6123669 0.91 C G14 −0.21 0.001474 BMP7 rs6014947 rs6123669 0.97 C G14 −0.21 0.001474 BMP7 rs230198 rs230198 N/A G G15 −0.25 0.004865 Other Embodiments

It is to be understood that while the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims. 

What is claimed is:
 1. A method of treating a human subject having schizophrenia, the method comprising: (a) selecting a human subject having schizophrenia; (b) performing an assay to determine an ankyrin-3 (ANK3) haplotype for the selected subject, wherein the ANK3 haplotype comprises an allele a single nucleotide polymorphism of: rs1551684, rs0761446, rs2393602, rs3750800, or rs10761451 and (c) administering; a treatment not comprising risperidone to a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs1551684; a treatment comprising olanzapine to a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs10761446; a treatment comprising risperidone to a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs2393602; a treatment not comprising perphenazine to a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs3750800; or a treatment comprising quetiapine to a selected subject identified as having an ANK3 haplotvpe comprising the G allele of single nucleotide polymorphism rs10761451.
 2. The method of claim 1, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs10761446; and step (c) comprises administering a treatment comprising olanzapine to a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs10761446.
 3. The method of claim 1, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs2393602; and step (c) comprises administering a treatment comprising risperidone to a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs2393602.
 4. The method of claim 1, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs1551684; and step (c) comprises administering a treatment not comprising risperidone to a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs1551684.
 5. The method of claim 1, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs3750800; and step (c) comprises administering a treatment not comprising perphenazine to a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs3750800.
 6. The method of claim 1, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs10761451; and step (c) comprises administering a treatment comprising quetiapine to a selected subject identified as having an ANK3 haplotype comprising the G allele of single nucleotide polymorphism rs10761451.
 7. The method of claim 1, wherein the selected subject is determined to have schizophrenia based, in part, on his or her Positive and Negative Syndrome Scale score.
 8. The method of claim 1, wherein the selected subject has: (a) a parent who has schizophrenia, schizophrenia disorder (SD), or schizotypal personality disorder (SPD); (b) a sibling who has schizophrenia, SD, or SPD; or (c) a second degree relative who has schizophrenia, SD, or SPD.
 9. The method of claim 1, further comprising obtaining a sample comprising genomic DNA from the selected subject.
 10. The method of claim 1, further comprising confirming a diagnosis of schizophrenia in the selected subject using psychometric instruments.
 11. The method of claim 1, further comprising selecting or excluding the selected subject for analysis of a clinical trial based on the haplotypes in the selected subjects.
 12. The method of claim 1, further comprising stratifying the selected subjects into biologically similar groups based on their haplotypes in order to determine a differential diagnosis.
 13. A method of treating a human subject having schizophrenia, the method comprising: (a) selecting a human subject having schizophrenia; (b) performing an assay to determine an ankyrin-3 (ANK3) haplotype for the selected subject, wherein the ANK3 haplotype comprises an allele of a single nucleotide polymorphism of rs1551684, rs10761446, rs2393602, rs3750800, or rs10761451; (c) selecting: a treatment not comprising risperidone for the selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs1551684; a treatment comprising olanzapine for a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs10761446; a treatment comprising risperidone to the selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs2393602; a treatment not comprising perphenazine to the selected subject identified as having an ANK3 haplotvpe comprising the A allele of single nucleotide polymorphism rs3750800; or a treatment comprising quetiapine to the selected subject identified as having an ANK3 haplotvpe comprising the G allele of single nucleotide polymorphism rs10761451; and (d) administering the selected treatment to the selected subject.
 14. The method of claim 13, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs10761446; and step (c) comprises selecting a treatment comprising olanzapine for a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs10761446.
 15. The method of claim 13, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism rs2393602; and step (c) the method comprises selecting a treatment comprising risperidone for a selected subject identified as having an ANK3 haplotype comprising the C allele of single nucleotide polymorphism rs2393602.
 16. The method of claim 13, wherein: the determined ANK3 haplotype comprises single nucleotide polymorphism rs1551684; and step (c) comprises selecting a treatment not comprising risperidone for a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs1551684.
 17. The method of claim 13, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs3750800; and step (c) comprises selecting a treatment not comprising perphenazine for a selected subject identified as having an ANK3 haplotype comprising the A allele of single nucleotide polymorphism rs3750800.
 18. The method of claim 13, wherein: the determined ANK3 haplotype comprises an allele of single nucleotide polymorphism Rs10761451; and step (c) comprises selecting a treatment comprising quetiapine for a selected subject identified as having an ANK3 haplotype comprising the G allele of single nucleotide polymorphism rs10761451.
 19. The method of claim 13, wherein the selected subject is determined to have schizophrenia based, in part, on his or her Positive and Negative Syndrome Scale score.
 20. The method of claim 13, wherein the selected subject has: (a) a parent who has schizophrenia, schizophrenia disorder (SD), or schizotypal personality disorder (SPD); (b) a sibling who has schizophrenia, SD, or SPD; or (c) a second degree relative who has schizophrenia, SD, or SPD.
 21. The method of claim 13, further comprising obtaining a sample comprising genomic DNAfrom the selected subject.
 22. The method of claim 13, further comprising confirming a diagnosis of schizophrenia in the selected subject using psychometric instruments.
 23. The method of claim 13, further comprising selecting or excluding the selected subject for analysis of a clinical trial based on the haplotypes in the selected subjects.
 24. The method of claim 13, further comprising stratifying the selected subjects into biologically similar groups based on their haplotypes in order to determine a differential diagnosis. 